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Full text of "Annual report of the Board of Visitors to the Dept. of Mental Hygiene"

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ALLEN COUNTY PUBLIC LIBRARY 



57 I 



GENEALOGY 
974 . 702 
N4E1MS 



3 1833 018216157 ■ 1904 
STATE OF NEW YORK 



Ninth Annual Report 



Manhattan State Hospital 



EAST, WARD'S ISLAND 



State Commission in Lunacy 



For the Year Ending September 30, 1904 



ALBANY 
BRANDOW PRINTING COMPANY 

State Legislative Printers. 
1905 



NINTH ANNUAL REPORT 



OF THE 



Manhattan State Hospital 

(The Manhattan State Hospital, East ; Ward's Island) 

AT NEW YORK 



STATE COMMISSION IN LUNACY 

For the Year Ending September 30, 1904 



OFFICERS 



BOARD OF VISITORS 

james McGregor smith william m. v. hoffman 
george d. mackay edward g. bailey 

Miss GRACE GILLETTE 

NON-RESIDENT MEDICAL OFFICERS 
Board of Consulting Physicians and Surgeons 
Austin Flint, M. D. Allan McLane Hamilton, M. D. 

Whitman V. White, M. D. Joseph D. Bryant, M. D. 

Edward G. Janeway, M. D. Edward D. Fisher, M. D. 
William H. Thomson, M. D. Bernard Sachs, M. D. 
Carlos F. MacDonald, M. D. William Hirsch, M. D. 
William C. Lusk, M. D. Pearce Bailey, M. D. 

W. Evelyn Porter, M. D. Ramon Guiteras, M. D. 

John L. Adams, M. D. Thomas P. Prout, M. D. 

Charles E. Quimby, M. D. Frederick Peterson, M. D. 

Curteniu.s Gillette, M. D. 

RESIDENT MEDICAL OFFICERS 

A. E. Macdonald, LL. B., M. D Superintendent 

J. T. W. Rowe, M. D First Assistant Physician 

Louis C. Pettit, M. D Second Assistant Physician 

D. S. Spellman, M. D Assistant Physician 

J. Rudolph Knapp, M. D Assistant Physician 

C. Floyd Haviland, M. D Assistant Physician 

Frank H. Magness, M. D Assistant Physician 

Philip C. Washburn, M. D Junior Physician 

Arthur M. Phillips, M. D Junior Physician 

James M. Parkinson, M. D Junior Physician 

Adelaide Turner, M. D Medical Interne 

Frank R. Haviland, M. D Medical Interne 

Alfred J. Fox, M. D Medical Interne 

Glanville Y. Rusk, M. D Assistant for Autopsies 

Treasurer 
A. E. Macdonald, M. D. 

Purchasing Steward 
Frederick A. Wheeler 

Resident Steward 
Edward F. Lawrence 



REPORT OF THE SUPERINTENDENT 



October 29, 1904 

State Commission in Lunacy, Albany, New York: 

Gentlemen: In accordance with the statutory requirements 
I have the honor to submit herewith the annual report of the super- 
intendent of the above-named hospital for the year ending Septem- 
ber 30, 1904. This will also constitute my last official communica- 
tion as superintendent of the hospital, my resignation of that office 
having, in pursuance of a long-intended purpose, been presented 
last spring and accepted by the Commission to take effect with the 
close of the State year. In thus ending a term of 35 years 
of public hospital service — over 30 years of it in connection with 
those for the insane on Ward's Island — I desire to express my best 
wishes for the progress and prosperity of the hospital and patients 
with which and whom I have been so long associated, and of those 
who continue in various relations and capacities to hold their inter- 
ests in charge. 

Following this report will be found the standard tables, prescribed 
by the State Commission for the State hospitals in general, and giv- 
ing the customary statistical details of the year's history. I incor- 
porate at this point a condensed statement showing the changes in 
population of this particular hospital during the year and the move- 
ments accounting for them. 

Number of insane in care of hospital Men Women Total 

October 1, 1903 1,361 500 1,861 

Admitted during the year 602 69 671 

Total number under treatment 1 , 963 569 2 , 532 

Number of patients discharged during 

the year. 293 51 344 

Number of patients died during the year . 204 18 222 

Total 497 69 566 

Number of patients remaining September 

30,1904 1,466 500 1,966 



4 Ninth Annual Report of the 

The above tabulation shows in a general way and in round num- 
bers, as compared with that of the preceding year, that the direct 
admissions have been less by about 100, while the direct dis- 
charges have been practically identical in number. The former 
fact is to be accounted for by the opening of the Manhattan State 
Hospital at Central Islip to the reception, during a portion of the 
year, of committed patients from the reception pavilion at Bellevue 
Hospital, instead of transferred patients from Ward's Island. As a 
consequence direct admissions to the East Hospital have been, in 
corresponding number, reduced. As a further consequence there 
has been a commensurate decrease in the number of recoveries, 
owing to the smaller number of acute, and, therefore, more probably 
curable cases received. On the other hand, the actual number of 
deaths is slightly less than in the year preceding. Taking per- 
centages instead of totals the year shows — as will be seen by special 
tables, also appended — a decreased ratio of recoveries and of deaths 
to the total number of patients, as was to be expected under the 
changed conditions of admission above mentioned. 

OVERCROWDING 

In my last annual report it became necessary to lay even more 
than the usual stress upon an usual topic of all annual reports, 
the serious overcrowding of the hospital buildings. At that time 
attention was called to the fact that during the 12 months 
then under discussion — October 1, 1902, to September 30, 1903 — the 
census had, without any enlargement of accommodations, increased 
by some 200 patients, and that, as a consequence, an alarming 
and dangerous degree of overcrowding — no less than 30 per 
cent over the actual capacity as certified under the law, by 
the Commission — had been reached. It was hoped then that immed- 
iate measures would be devised whereby this grave menace might 
be overcome; it was not for a moment supposed that another year 
would witness its aggravation instead of its amelioration. Yet, 
as will be seen by the above table, the accommodations, not only 
unenlarged, but, on the contrary still further reduced, have been 
forced to receive a further excess of 100 patients. With 1.966 
actual inmates and a certified capacity of but 1,425, the percent- 
age of overcrowding has risen to 38, according to the last available 
published figures of the commission. From the same source, the 
overcrowding in the 13 other hospitals of the State system is found 
to vary from none at all to 37 per cent, the latter applying to the 
Manhattan State Hospital, west, also on Ward's Island. The Man- 



Manhattan State Hospital, East, Ward's Island. ."> 

hattan State Hospital at Central Islip which, as a branch of the New 
York City Asylums for the Insane, and prior to their transfer to the 
State, was specifically designed and erected for the express purpose of 
relieving the overcrowding of the Ward's Island buildings, suffered at 
the same time overcrowding to the extent of less than 15 per cent, and 
part of its population was made up of patients transferred past the 
doors of the Ward's Island hospitals, from a hospital at the extreme 
opposite border of the State, and which as a result shows in the 
same table a degree of overcrowding of the comparatively com- 
fortable dimensions of less than two per cent. As for any immediate 
prospect of better things in the future the only measurable indication 
would seem to be found in the action of the Legislature of the State 
in the course of its last session, and that indication can scarcely be 
regarded as hopeful. Under then existing statutes, codified into 
the amended constitution of the State of 1894, it was made the pre- 
rogative and duty of the State Commission in Lunacy to "provide 
sufficient accommodations for the prospective wants of the poor and 
indigent insane of the State. To prevent overcrowding in the State 
hospitals it shall recommend to the legislature the establishment 
of other State hospitals in such parts of the State as in their judgment 
will best meet the requirements of such insane. " By the special en- 
actment referred to this duty was so far abrogated, or at least 
modified, that the location of the next State hospital for the care of the 
insane was determined approximately by the Legislature and not by 
the Commission, and determined at that in favor of a locality which 
whatever its intrinsic need and availability may be, cannot, in 
those respects, be seriously claimed to compare with several other 
localities in the State, and especially with that assigned district — 
the city of Greater New York — from which the Manhattan State 
Hospitals have to receive primarily all the insane. 

What could be done by the officers of the hospital under the 
existing limitations of their power in the premises, has been done 
to keep down the surplus population. Careful examination from 
day to day by members of the staff, of patients presented for admis- 
sion from the pavilion at Bellevue Hospital, has resulted in the re- 
jection, in the exercise of the discretionary power conferred by the 
law upon the superintendent, of 15 cases, for the most part, 
imbeciles or dotards, who were not considered fit subjects for treat- 
ment in a hospital for the insane. On the other hand, a number 
of aliens and non-residents who had been admitted from time to 
time through ignorance or concealment of the facts as to their cit- 
izenship, have, upon their discovery, been returned to their homes 



Ninth Annual Report of the 

in this country or deported through the agency of the emigration 
department to the foreign countries whence they came. Through 
changes in the" statutes regulating immigration, and the active 
assistance of the present U. S. Commissioner, the Hon. William 
Williams, 20 such aliens have been so returned during the past 
year. Direct communication between the commissioner and the 
hospital superintendent now being permitted in such cases, instead 
of the former slow and cumbersome method of negotiation through 
the Albany office, not only has the number of deportations increased, 
but the average time taken in accomplishing them has been dimin- 
ished. As a result the aliens' part in adding to the overcrowding 
has been minimized, while a reversal of the former ruling — that 
the State should be reimbursed by the steamship companies respon- 
sible only for the time elapsing between the granting of the order of 
deportation and its accomplishment — adds to the State's revenue, 
while at the same time its outlay is curtailed. 

AMUSEMENTS 

The traditions of the hospital as to the association of amuse- 
ments with employment as influential elements in the less purely med- 
ical treatment of insanity have been followed, if anything, with 
increasing thoroughness during the year just closed. Apparatus 
has been added to the equipment of the indoor gymnasium, which, 
with the bowling alley affords means of active physical exercise when 
inclement weather prevents going outdoors, and similar additions to 
the list of indoor games and musical instruments enlarge the oppor- 
tunities for the more mental forms of recreation. Outdoor games 
have been in full practice upon every favorable day, and upon the 
standard holidays of the milder months of the year, Decoration 
day, Independence day, and Labor day, have developed into more 
formal sports, given under a definite programme, with prizes for the 
winners and refreshments for the onlookers, including general 
visitors and such of the patients' relatives and friends as cared to 
attend. Upon one occasion, Independence day, no less than 609 
of the last-named were present, with 1,845 patients from this hospital, 
and 200 from the neighboring Manhattan State Hospital,- West, 
making the total attendance, with the officers and employees in 
charge, no less than 3,190. The programme of this holiday is 
subjoined. 



Manhattan State Hospital, East, Ward's Island. 7 

PROGRAMME OF SPORTS BY PATIENTS AND EMPLOYEES, 
INDEPENDENCE DAY, JULY 4, 1904, ON THE 
GROUNDS OF THE HOSPITAL 

MORNING PROGRAMME 

Baseball, patients. Prizes, a silk tie and box of candy to mem- 
bers of winning team. 

Lawn bowls, patients. First prize, pair of suspenders; second 
prize, box of candy. 

Swimming race, male patients. First prize, pair of suspenders 
and silk tie; second prize, box of candy and pocket comb. 

AFTERNOON PROGRAMME 

100-yard dash, patients. First prize, silk scarf; second prize, 
pair of suspenders. 

Potato race, women patients. First prize, fan; second prize, box 
of candy. 

Crab race. First prize, silk tie and pocket comb; second prize, 
box of candy. 

Tug of war, men patients. Prize, large United States flag to 
members of winning team. 

Running broad jump, patients. First prize, silk tie and pair of 
suspenders; second prize, silk tie. 

Relay race, patients vs employees, distance, one mile. Prizes, 
a belt to each member of winning team. 

Sack race, 100 yards, patients. First prize, pocket comb and pair 
of suspenders; second prize, silk tie and box of candy. 

Shoe race, 75 yards, male patients. First prize, pocket comb and 
belt; second prize, pair of suspenders. 

100-yard dash, handicap, page boys. First prize, baseball; sec- 
ond prize, pair of suspenders. 

Three-legged race, 100 yards, male patients. First prize, two 
belts; second prize, two silk ties. 

Tug of war, women patients. Prizes, four silk handkerchiefs and 
six fans to members of winning team. 

120-yard hurdle race, employees. First prize, umbrella; second 
prize, cane. 

Wheelbarrow race, 100 yards, male patients. First prize, silk 
tie and pocket comb; second prize, pair of suspenders. 

75-yard dash, women patients. First prize, silk tie and pair of 
side combs; second prize, box of candy and back comb. 

Tug of war, employees. Prizes, a silk tie to each member of 
winning team. 



8 Ninth Annual Report of the 

Distribution of Prizes 
Music by the Hospital Band 

PROGRAMME 

March — " Blue Bell" Haviland 

Medley Selection — " Suwanee River" Tilzer 

Waltz—" Dreamland " Clark 

Two Step— "Dolly Dimple" Haines 

Caprice — " Yankee Consul " Robyn 

March—" On Duty " Rosey 

Selection — " Opera Comique " Laurendeau 

Waltz — " Gloaming " ..' Herman 

Two Step— "New York Belle" Tilzer- 

Galop — " On the Wing " Fischer 

For the holidays occurring in the less clement seasons, indoor 
concerts and balls have been substituted with the customary dinner 
at Thanksgiving and the customary tree at Christmas. Dances, 
concerts and stereopticon exhibitions have also been regularly pro- 
vided in season, the hospital band under the continued leadership 
of Mr. C. J. Crowley, bandmaster of the Eighth Regiment of the 
New, York State) National Guard, not only assisting upon these 
special occasions, but playing from day to day, throughout the year, 
in some portion of the grounds or within the buildings. In summer 
the hospital steamer "Wanderer" is made use of for excursions in 
different directions for selected parties of male and female patients 
alternately, 26 [such excursions having been made during the 
year under report. What may be considered another form of 
outdoor amusement in view of the spirit in which the patients enter 
into it is the use during the warmer months of the large, outdoor, 
salt-water bath quarried out of the solid rock to the length and width 
of 200, and 45 feet, respectively, and with an average depth of about 
5? feet. This bath is adjacent to the shore of the island, supplied with 
salt water through the free ingress of the daily tides, and is fitted with 
fresh-water showers, dressing pavilions, etc. A total of 1,297 
individual patients has made use of this bath upon one day, 
July 20th, of the season, while the grand total of the season, extend- 
ing from June 20th to September 30th, foots up 63,125. To this 
grand total the patients of the West Hospital contributed to the 
numbe r of 11,416, certain designated days and hours of each 
week being assigned for their accommodation. The service per- 
formed by this bath in summer is met, so far as possible, during the 
remainder of the year by an indoor bathing plant situated in the 



Manhattan State Hospital, East, Ward's Island. !) 

basement of the main building, and supplementing the smaller 
plants attached to each ward. Its main feature is a marble-lined 
plunge-tank of the dimensions of 20 by 11 J by 3 feet, with acces- 
sory showers, etc., hot and cold, fresh and salt water being provided 
for each. 

TRAINING SCHOOL FOR NURSES 
The Training School entered upon its eighth year on October 1, 
1903, with an attendance of 11 in the senior and 22 in the junior 
class. Following the close, early in April, 1904, of the course of 
lectures, demonstrations and recitations, which were as usual con- 
ducted by the physicians of the hospital staff, examinations 
were held, at which questions prepared by a committee of hospital 
superintendents, and sent to the examination-room under seal, were 
answered by the competitors in writing. These answers, again 
under seal, were returned to the committee, composed upon this 
occasion of Dr. E. H. Howard, superintendent of the Rochester 
State Hospital, Dr. Charles G. Wagner, superintendent of the Bing- 
hamton State Hospital, and Dr. Arthur W. Hurd, superintendent 
of the Buffalo State Hospital, and in due course examined and marked 
by those gentlemen. As a result 11 of the members of the senior 
class were found to have secured the necessary marks (75 per cent 
of the total) to qualify them for graduation, while 13 were suc- 
cessful in qualifying for promotion from the junior to the senior 
class, and will enter the latter with the reopening of the school 
this autumn. The successful candidates, together with those from 
the other branches of the Manhattan State Hospital at Ward's Isl- 
and, West, and Central Islip, were presented with their diplomas on 
the twenty-fifth of May, 1904, when the annual commencement 
exercises of the Training School were held in accordance with the 
appended programme. 

SEVENTH ANNUAL GRADUATION EXERCISES OF THE 

TRAINING SCHOOL FOR NURSES 

Ward's Island, New York City, May 25, 1904 

Overture — " Raymond " (Band) Thomas 

Invocation 

Rev. Alfred Blewitt 

Hospital Chaplain 

Address 

Geo. D. Mackay, Esq. 

Member Board of Visitors 



10 Ninth Annual Report of the 

March—" Blue Bell " (Band) Rowley 

Presentation of Diplomas 

Mrs. Herbert L. Satterlee 

Miss Florence M. Rhett 

Visitors, State Charities Aid Association 

Canzonetta — " Felice " (Orchestra) Langey 

Address 

Dr. William H. Thomson 

Member Board of Consulting Physicians and Surgeons 

Benediction 

Rev. Rufus Duff 

Hospital Chaplain 

Waltz— "Chanticleer/' (Band) Hillier 

(Music by the Band of the Manhattan State Hospital, East, and the 
Orchestra of the Manhattan State Hospital, West.) 

GRADUATES 

Annie M. Byron, William Meehan, 

Lizzie Galvin, Katie Donohue, 

Delia O'Connell, Mary Mitchell, 

Catherine Keenan, Mary McFaull, 

Patrick Casey, Mary Ryan, 

Annie E. Reilly. 

IMPROVEMENTS 

The list of subjects of which annual reports like the present are 
required to take cognizance is prescribed, under the law by the State 
Commission, and one of its items corresponds with the above head- 
ing. Under this heading in the eight annual reports that have 
already been prepared and submitted since the transfer of this hos- 
pital from the care of the city to that of the State, the items have 
been largely repetitions, year after year passing without recognition 
of their urgency, or at least without practical outcome of such 
recognition. It has been customary to accompany each item with a 
statement of the arguments in support of its claim for attention, and 
these too have been duplicated and reduplicated not only in suc- 
cessive annual reports, but in other written communications from 
time to time, supplemented by verbal submissions, practical demon- 
strations, and personal appeals, upon the occasions of visits of 
commissioners and other officials to the hospital. Believing that 
the merits and necessities of the various recommendations must be, 
by this time, at least thoroughly understood, and especially in view 



Manhattan State Hospital, East, Ward's Island. 1 1 

of the fact that any further appeal or action must come within the 
term of my successor in office and not my own, I content myself 
with simply enumerating without elaborate explanation the prin- 
cipal items of expenditure, which are repeated from former lists, 
which still appear to me to be necessary to the proper equipment, 
maintenance and administration of the hospital. 

Recourse may be had to former annual reports if explanations 
regarding them are required. The list is as follows: 

Cementing salt-water bath $1 ,400 00 

Posts and trestle for support of upper floors and roof of 

main boiler house '. 1 , 000 00 

Change in electrical plant and lines 1 ,000 00 

Shed for vehicles and general storage purposes 1 , 000 00 

Painting basement, main building 1 ,500 00 

Coal shed and scale, main boiler house 600 00 

Repairs to sea wall . 7 , 500 00 

Renewal of east dock 10,000 00 

Stone for new roads and repairs to existing roads 500 00 

Blacksmith shop 350 00 

Steam pump, east building boiler house 400 00 

Fire alarm system 450 00 

Renewal of steam piping and clothes-horses, drying 

room, laundry, main building 1 ,000 00 

Piggery 1 ,500 00 

Greenhouse (foundation in place) 2, 100 00 

Kitchen apparatus and ventilation, east building 

kitchen 1 ,200 00 

Resetting seven boilers, main boiler house, furnishing 

new feed pipe and general repairs, new half fronts. . 7,000 00 
Repairing and rebracing two hot-water tanks, main 

building 300 00 

New steam and return mains, traps, valves, etc., main 

building 9 ,000 00 

Trees 200 00 



Following the above list, which is made up of items that have 
already, at some time, been submitted and explained, I now submit 
a further list with brief explanations of new items, as follows: 

Repairs to coal dock $1 ,500 00 

In previous estimates, which were not allowed, the 
cost was placed at $500. The dock has now so far 
further deteriorated that the cost of the necessary repairs 
will probably reach the figure now quoted. 



12 Ninth Annual Report of the 

Repairs and renewals of plumbing system $15,000 00 

This figure represents the approximate cost of replacing 
all the dilapidated plumbing now in use at the main and 
east buildings, which is of old and abandoned designs, and 
so worn out and offensive as to be dangerous to the health 
and lives of the hospital's inmates. 

Trees 200 00 

It has been customary from year to year to purchase 
and plant shade trees in place of old trees dying or de- 
stroyed by storms, and this amount is required for that 
purpose. 

General repairs, east building (renewals of woodwork, 

glazing and reputtying sash, window screens, etc.) . . 8,000 00 

The sum of $6,500 was asked for in 1902 and $2,000 
was allotted for painters' labor and material. The latter 
was purchased, but no work has been done owing to the 
fact that until carpenters' and other necessary work for 
which no funds are available is done, painting would be a 
waste of time and money. 

Repairs to roofs 1 ,000 00 

This amount is asked for to cover the expense of remedy- 
ing the deterioration due to wear and tear of the seasons, 
as after every storm repairs are needed to roofs and towers. 

Material and labor for repairing and painting wards 

in main and east buildings 3 , 000 00 

Several wards in the main and east buildings require 
renovating and painting; the plaster is falling and the 
woodwork shows marked deterioration and should be 
removed and proper repairs made without delay. Those 
in the worst condition can be renovated with this amount. 
Inside iron window guards, wards 5, 6, 9, 12 and 19. . . . 1,250 00 

The window guards in these wards are very dilapi- 
dated and from old age are becoming loose and falling 
in pieces. 

Repairing and painting new kitchen and employees' din- 
ing rooms, upstairs 592 69 

The usual painting, etc., has never been done in this 
building since its erection and it is already in need of 
repairs as the walls are cracking and breaking down, 
and the woodwork has deteriorated very rapidly. Its 
roof was in a leaky condition when the building was first 
occupied and has become worse since. 



Manhattan State Hospital, East, Ward's Island. 13 

Removing buttresses, refitting, etc., in ward 16 for exten- 
sion of tailor shop $300 00 

The present shop does not furnish the required ac- 
commodation for the number of patients employed, and 
by this small outlay suitable additional room can be 
obtained. 

Tents 3,000 00 

This amount is designed to continue and enlarge the 
system of tent treatment of the tuberculous and other 
classes which for years past has shown such gratifying 
results among the patients of the hospital. 

Steel ceilings 1,200 00 

The ceilings in wards 5, 6, 7 and 22 of the main building 
are cracked and loose and demand frequent repairs. 
This amount is required to provide metal ceilings in 
these wards as has already been done in others, and so 
save expense and add to the appearance and safety of 
the wards. 

Storehouse for vegetables 1 f 500 00 



This is an obvious necessity at a hospital where large 
quantities of vegetables are raised, and purchases of 
other large quantities are made in advance of its re- 
quirements, necessitating storage room. 

Failure to provide one has already entailed losses far in 
excess of its estimated cost. 

During the year to which the present report refers 
extraordinary repairs and improvements have been 
completed as follows and at the cost given in each case: 

Bathroom and fixtures for medical staff $241 03 

Outside stairway and fire-escape, ward 12 460 00 

Hot-water tank, main boiler house 445 00 

Repairs to roofs 399 75 

Remodeling of old kitchen, main building. 738 31 

New steps on fire-escapes, main and east buildings. . . . 2,501 00 

Steel ceilings 660 00 

Painting all sash and window frames, main building .... 1 , 586 83 



Other items of extraordinary repairs and improvements 
which are in course of prosecution but have not yet 
been completed, and their status severally at the date 
of report, together with the amounts estimated, are as 
follows : 



14 Ninth Annual Report of the 

Repairs to roofs $3 ,000 00 

Two roofers and a helper are still engaged upon the 
work necessary, which is approximately one-quarter 
done. 

Repairs and renewals of plumbing system/wards 14,19 and 
22, and basement, center main building, and wards 

A, B and C, and top floor, center east building 7,324 00 

The contract is not yet completed, although portions 
of the work are in full use where possible and in partial 
use elsewhere. The w T ork done is unsatisfactory in many 
respects, and extensive alterations will be required to 
put it in proper condition for use. 

Tents and equipment "."..' 2,000 00 



Of the above amount $1,420.18 was allowed and ex- 
pended in necessary repairs and renewals and in partial 
fulfillment of plans for the extension of the system to 
other classes, and larger numbers of the hospital's 
patients. 

MEDICAL SERVICE 

While the diversion elsewhere referred to, during five months of 
the year, of recent and more curable cases from this hospital to that 
at Central Islip has, of course, lessened the possibilities of successful 
medical treatment, the results will in the main compare favorably 
with those of former years. The fortunate immunity of this par- 
ticular hospital from the admission or development of contagious 
or infectious diseases has continued for another year, and the general 
health of the inmates and employees has been comparatively satis- 
factory. Means of treatment and of medical research have been 
amplified, and, as in former years, full employment has been given 
to the electro-therapeutic and hydro-therapeutic apparatus and other 
accessories. In the local pathological laboratory the members of 
the hospital staff have given full attention to the examinations and 
other work still left open to them, and similarly with the grosser 
post-mortem investigations. Urinary analysis is made at the time 
of admission in the case of all patients, and from time to time there- 
after as occasion may arise, and the blood and sputa are also the 
subjects of frequent examination, and especially with the view of 
early detection of tuberculous conditions and the isolation of patients 
in whom they are found to be present. In the cases of 38 
patients dying in the hospital within the year autopsies have been 
held, the consent of the nearest relatives or friends being obtained 



Manhattan State Hospital, East, Ward's Island. 15 

when such were recorded in the hospital books. The observed re- 
sults of these autopsies have been carefully noted, and the material 
for such further investigation as is assigned to the Pathological Insti- 
tute has been transmitted to its director for that purpose. 

The most substantial addition to the equipment of the hospital 
during the year consists in well-arranged operating rooms in the 
east building, occupied by the women patients. For this purpose 
one large and two smaller adjoining rooms were appropriated, 
and after being stripped of their former furnishings and fittings, were 
remodeled with tiled floors and wainscots and antiseptic appliances 
of all kinds, steam sterilizing apparatus and the like. The use and 
value of this improvement is shown from the fact that within the 
year in the gynecological service under charge of Dr. W. Evelyn 
Porter, of the consulting staff, no less than 35 operations have 
been performed and with great resulting benefit to the patients 
concerned. The women patients sent to this particular hospital 
are all cases of prolonged chronic insanity, for the most part in poor 
bodily condition, and the physical complications calling for operation 
are generally also of a chronic nature, unameliorated by attention and 
treatment. The time for radical improvement and especially for 
beneficial effect upon the course of the attendant insanity has, 
therefore, unfortunately passed. But the results of operation have 
been to put the patients in much more comfortable condition, to re- 
lieve the physicians and nurses of much unpleasant and exacting 
attention to merely palliative measures, and, incidentally, to show the 
importance of early recognition and action at the hospitals to which 
such patients are first consigned following the outbreak of their 
insanity. It was intended to follow the construction and equipment 
of the operating rooms referred to by similar provision at the main 
building, occupied by men patients, for the proper performance 
of the various operations so often required by its inmates. It was 
hoped that the year covered by this report might witness the com- 
mencement and material advancement, if not indeed the completion, 
of this most necessary work. To this end the Commission having 
signified its approval of the scheme and its intention to forward it, 
surveys were made and plans prepared by the state architect, the 
general principles of which were passed upon and approved by 
the members of the consulting board principally interested. At this 
juncture, however, the Commission found occasion to reconsider 
its favorable attitude, and the year closes with this, in common with 
other much-needed improvements in abeyance. Notwithstanding 
this disapointment, Dr. Ramon Guiteras and Dr. William C. Lusk,. 



16 Ninth Annual Report of the 

of the consulting board, in their several departments of general 
surgery and rectal surgery, have performed a number of important 
operations with generally marked benefit to their subjects. Dr. 
Joseph D. Bryant has cooperated with his colleagues in this depart- 
ment in the examination of patients where the question of the 
advisability of operation has arisen. Dr. William H. Thomson, 
also of the consulting board, has, in addition to other services, in- 
augurated a series of investigations as to the relation of epilepsy to 
insanity as found in the large number of patients in the hospital 
presenting that grave association of diseases. In the conduct of these 
observations he has had the assistance of Dr. Robert C. Kemp and 
Dr. C. T. Graham-Rogers. 

Four members of the consulting board are connected with the 
teaching staffs of the three principal medical colleges of the city of 
New York in the departments having relation to the insane, and 
patients from this hospital have during the year, as in former years, 
been placed at the disposal of these gentlemen for the purpose of 
practical illustration of their lectures. At stated seasons, the steamer 
and ambulance of the hospital have conveyed such patients to 
the clinics of Professor Carlos F. MacDonald, at the University and 
Bellevue Hospital Medical College, and to those of Professor Frederick 
Peterson at the College of Physicians and Surgeons. The clinics 
of Professor Allan McLane Hamilton of the medical department of 
Cornell University have been held at the hospital by his chief of 
clinic, Dr. William Hirsch. 

In view of the completion at the date of this report of a period of 
over three years, during which the experiment of tent treatment 
of the insane 7 and especially the tuberculous insane, has been given 
thorough trial, and in view also of the further fact that my own relation 
to the experiment, and to the hospital, terminates at the same time, 
I think it well to introduce in this connection a summary of the 
results and conclusions of the experiment. This summary is in 
the main identical with a contribution prepared for, and appearing in 
"A Directory of Institutions and Societies dealing with Tubercu- 
losis," as issued conjointly under the editorship of Miss Lilian 
Brandt, by the Charity Organization of New York, and the National 
Association for the Study and Prevention of Tuberculosis. 

NOTES ON CAMPS— GENERAL 
A. E. Macdonald, M. D. 
That consumptive insane patients may be kept and treated to their 
advantage and incidentally to the advantage of their fellow-inmates 



Manhattan State Hospital, East, Ward's Island. 17 

in canvas tents, and throughout the several seasons of the year, 
would appear to have been demonstrated in the recent history of this 
hospital. The experiment upon the success of which this claim is ad- 
vanced has, at the date of this writing, September 30, 1904, covered 
a period of 40 months, the camp having been first established and 
occupied by patients on June 5, 1901. 

The serious problem of caring for this class of patients had, prior 
to that date, embarrassed this particular hospital with others, 
and with added seriousness, from the fact that insane men had 
to be dealt with, and that the form of construction of the hospital 
buildings was such that no smaller wards or sections, adaptable to 
necessary isolation, were available. In all hospitals for the insane-the 
form of insanity properly constitutes the prevailing basis for class- 
ification, modified, of course, by such secondary considerations as the 
patient's physical condition, progress toward recovery or the reverse, 
and other elements. To set up another standard, the presence of a 
bodily diseased condition, and to assemble all patients suffering from 
it, without regard to any associated conditions or circumstances, is 
a difficult undertaking, involving, among other departures from 
routine practice, the association of disturbed and dangerous with 
demented and harmless patients, and so on through all the inter- 
mediate degrees. This, too, has been accomplished, and with un- 
expected ease and success. 

The first intention and expectation were that, by possibility, the 
consumptive insane patients, or a majority of them, might be re- 
moved from contact with their fellows for some months, perhaps as 
many as five months, during the milder season of the year, with 
the attendant advantage of freeing, for the time being, correspond- 
ing space in the permanent buildings, and affording opportunity for 
disinfection and renovation. 

Study was made of the arrangement of hospital tents and acces- 
sories in the exhibit by the United States Army Hospital Corps at 
the Pan-American Exposition then in progress at Buffalo, and vis- 
its were made for the same purpose to army posts in the vicinity of 
New York city. 

The camp first established consisted of two large dormitory 
tents — 20 by 40 feet — each containing 20 beds, with smaller tents 
of different shapes, about 10 by 10 feet, for the accommoda- 
tion of the nurses, the care of hospital stores, pantries and a dining- 
tent for such patients as were able to leave their beds and tents and 
go to the table for their meals. Running water was secured by means 
of underground pipes, and the safe disposal of waste and sewage was 
also specially provided for. 
2 



IS Ninth Annual Report of the 

As has been said, it was expected to continue the camp only 
through the summer and as far into the autumn as favorable weather 
might render justifiable. But Avhen in the late autumn it was found 
that the favorable experience continued, it was decided to attempt 
to carry the experiment, on a modified scale, into or even through 
the approaching winter. The camp, as first established, had been 
placed upon an elevated knoll adjacent to the river side and pur- 
posely exposed to the full force of the summer breezes. For the 
winter experiment its site was removed to the center of the island, 
where trees and buildings interposed to act as a wind-break to the 
severe storms from the east and northeast which are to be expected 
in this locality. The number of patients was reduced to 20, 
those in whom the disease was most active being retained and the 
others being returned, for the time being and much against their 
will, to the buildings. One large tent sufficed for the housing at 
night of the reduced number of patients, and one was set apart as a 
sitting-room for day use, with the accessory tents before mentioned, 
and large stoves were placed in them, here and there, with wire 
screens surrounding them to protect the patients, and a liberal use 
of asbestos and other fireproof material and arrangements for the 
prevention of fire. Better resistance to the force of the expected 
gales was secured by stronger and more numerous guy-ropes and 
anchorages, and slatted wooden movable pathways were prepared 
which might furnish means of passage between the tents Avhen snow 
and slush should come. Thus equipped the coming of winter was 
awaited with the expectation that the 20 survivors must sooner 
or later follow their fellows into the shelter of the permanent build- 
ings, and with every preparation made for immediate evacuation 
and retreat. The most sanguine hope did not go beyond this point. 
As the weeks passed, however, and the patients continued comfortable 
evacuation was deferred until a severe storm occurred. Then it 
was found that, in spite of high wind and snow, a more equable tem- 
perature had been maintained and less discomfort caused in the 
tents than in the hospital wards most exposed to the force of the 
gale. From that experience, followed by other confirmatory ones, 
resulted the reconsideration of the design to evacuate the camp. 

To make a long story short, it has remained in continuous use, 
not only throughout the first winter, but through the two succeeding 
winters and intervening seasons, up to the date of the present writ- 
ing. The scope of its employment has been gradually enlarged 
until all patients in whom there are active manifestations of phthis- 



Manhattan State Hospital, East, Ward's Island. 19 

ical process — an average of 43 out of a total census of about 
2,000 — are isolated therein, and there has been parallel enlargement 
of the elements of the plant. 

The success of the first-established camp — that for the tuberculous 
insane — has led to the extension of the tent treatment for the insane, 
at this hospital, to several other classes of patients. Following the 
experiences and results of the first winter, as above summarized, 
the tuberculosis camp was in the spring re-enlarged to its full capac- 
ity, and has remained in full use ever since, so that every patient 
showing the least activity of symptoms is not only afforded for him- 
self the advantage of the outdoor treatment, but is removed from 
possible danger of injurious influence upon his neighbors. Each 
year also an additional camp for another class of the insane has been 
put in commission: One in 1901, Camp "B," for demented and 
uncleanly men, many of them bedridden, whose emancipation from 
the wards was a great gain, both for themselves and for the hospital 
conditions generally; one in 1902, Camp "C," for feeble and decrepit 
women, who were losing the benefits of outdoor life because the high 
levels and long stairways of the buildings were a prohibition to 
egress and ingress; one in 1903, Camp "D," for convalescing patients, 
and those mainly from among the workers in the printing office, 
the shoe shop and the tailor shop, so that they might enjoy, in the 
non-working hours and especially at night, the advantages of which 
their indoor employments deprived them during the greater portion 
of the day; and, lastly, one in 1904, Camp "E," of 40 beds, as an 
accessory to the acute hospital service, where patients for the most 
part confined to bed and suffering from various concurrent diseases 
added to their insanity, find an agreeable and beneficial change 
from the ordinary surroundings of the hospital sick-room. In all, 
during the summer just past and at this date, 230 patients 
have been and are undergoing tent treatment, an average of 
43 — all consumptives — remaining in Camp "A" throughout the 
year, and the others as long as favorable weather continues. In 
1903 Camp " B " continued in commission from June 1 to November 
30, Camp "C" from June 1 to October 15, Camp "D" from June 1 
to November 30, and Camp "E" was opened on July 1, 1904, and, 
with the several others, is still (September 30) in use. 

The isolation of the tuberculous patients has reduced to a min- 
imum the danger of infection of other patients and of employees. 
The patients themselves have suffered no injury or hardship, but 
have, on the contrary, been unmistakably benefited. This is shown, 
among other ways, by a decrease in the death rate from pulmonary 



20 Ninth Annual Report of the 

tuberculosis, both absolute and relative, and by a marked general 
increase in bodily weight, amounting in the case of one patient to 
an actual doubling of weight — from 83 to 166 pounds — in 14 months 
of camp residence. 

I prefer to advance these proofs, as they depend upon figures 
which are not capable of manipulation, rather than the usual per- 
centage calculations of "improvements," and especially of "recov- 
eries," which are in great part notoriously unreliable. Several 
patients whose mental improvement permitted of their absolute 
discharge have left the hospital with the pulmonary disease also 
to all appearances completely arrested. Others whose condition in 
the latter respect was similar have been returned, their insanity 
still continuing, from the tents to the wards, and after periods ex- 
tending in individuals as long as two years, continue, as far as can 
be found upon most thorough investigation, immune from reappear- 
ance of the disease. In other such cases again, although these are 
fewer in number, confinement to the wards has resulted in return of 
phthisical manifestations; but even in this most unfavorable class 
the benefits of the outdoor system have been demonstrated, for 
invariably improvement has again speedily followed upon their 
prompt return to the camp. Mental improvement has as a general 
rule been the concomitant of physical, among the patients in the 
tuberculosis camp as well as in the others, and in the former class this 
has been somewhat of an anomaly. My experience, and I think that 
of others, has been that when phthisis and insanity co-exist they 
are apt to alternate as to the prominence of their several manifes- 
tations — the mental symptoms being more pronounced, whilst the 
physical are in abeyance and vice versa. Under the tent-treatment 
we have found a more general disposition toward accord in the man- 
ifestations, improvement in both respects proceeding concurrently, 
and some of the discharges from the hospital which gave most 
satisfaction to us at the time, and most assurance for the patient's 
future, were of inmates of the tuberculosis camp. 

The mental improvement, even in cases where recovery was not 
to be looked for, has been a gratifying feature of the camp experiment, 
and depending largely, as it has, upon the patient's satisfaction 
with his new surroundings, has served to dispel one of the doubts 
with which the experiment was undertaken. It was apprehended 
not only that the patients themselves might resent their transfer, 
but that similar objection might come from their relatives and 
friends, since innovations, even progressive ones, are apt to be 
frowned upon by those who constitute the majority in the clientele 



Manhattan State Hospital, East, Ward's Island. 21 

of a public hospital in a cosmopolitan city. Even at the outset, 
however, the protests, whether from patients or their friends, were 
surprisingly few, and latterly they have been more apt to arise, if 
at all, over the patient's return to the buildings when that became 
necessary. Throughout the winter months constant and anxious 
inquiries have been made, both by patients who had been in the 
non-tuberculosis camps and by their visitors, as to how early in the 
spring the former might expect to resume their camp life. 

The question of medication may, in the present writing, be dis- 
missed with a very brief reference. It has been found unnecessary 
to extend it greatly, and it has been limited mainly to the treatment 
of symptoms. Stimulation — alcoholic and the like — has been 
found of but little demand or use, and the quantities of stimulants 
consumed — always under individual medical prescription — have 
been insignificant. On the other hand, the dietary has been made 
as liberal as the imposed restrictions of the State hospital schedule 
have permitted, both in the way of regular diet and extras, and 
in the leading essentials — milk and eggs — private donations have 
supplemented the regular supply. But dependence, after all, has 
been mainly placed upon rigid isolation and disinfection, and upon 
the unlimited supply of fresh air. As an interesting incidental fact , 
it may be mentioned that not only the patients, but also the nurses 
living in the camp have enjoyed almost complete immunity from 
other pulmonary diseases. Not a single case of pneumonia has de- 
veloped in the camp in its existence of over three years, though it 
caused 131 deaths in the hospital proper in that time. The " common 
colds" so frequent among their fellows living upon the wards, or in 
the attendants' home, have been unknown among the tent-dwellers. 

The popular idea that the consumptive is a doomed man unless he 
can at once abandon home and family and business and betake 
himself to some remote region would seem to be negatived by our 
experience. So also with the strenuous claims for high altitude. 

The Ward's Island camp is but a few feet aboA r e the tide-water 
level, its site is swept in winter by winds of high velocity, coming 
over the ice-bound waters of the rivers and the sound which surround 
it, and it suffers as much as, or more than, any other part of the 
city of New York from the trying changes of temperature and humid- 
ity which are so characteristic of its climate. If, in spite of all these 
drawbacks, what has been done can be done, and that for insane 
patients, what may not be hoped from the extension of the same 
methods to the ordinary consumptive of sound mind, anxious for 
recovery, and capable of giving intelligent assistance in the struggle? 



22 Ninth Annual Report of the 

The continuance and extension of the camp system of treatment 
and accommodation for the insane, inaugurated at this hospital in 
1901, forms this year again a noteworthy element in the year's 
history. In my report of last year after summarizing the benefits 
already obtained, I recommended such additions and enlargements 
as would make the camps available for both a larger number and 
additional classes of the patients, and suggested that in time, if 
not immediately, some of the employees might be glad to avail them- 
selves of the opportunity during the summer months of camping out. 
As a necessary means to the carrying out of this recommendation 
the sum of $2,000 was inserted in the preliminary estimate, sub- 
mitted at the beginning of the year, of proposed expenditures for 
extraordinary improvements. The recommendation and appro- 
priation met the approval of the then medical Commissioner, Dr. 
Peterson, but following that gentleman's retirement, reconsideration 
was had, and the appropriation was denied upon the ground of 
economy, it being claimed that wooden sheds could be erected which 
would last longer and therefore prove less expensive in the end. 
It is by no means certain that this utilitarian argument rests upon 
solid foundation; on the contrary I believe that it can be demon- 
strated that the canvas tent is actually the cheaper structure, apart 
from being immeasurably superior from other points of view. Into 
this particular question, however, as well as into the more general 
one as to whether the mere matter of cheapness should prevail in the 
determination of expenditures in behalf of the insane, it is not neces- 
sary at this juncture to enter. Dr. William Mabon, succeeding Dr. 
Peterson as medical member and president of the Commission, 
fortunately entertained the same broad views as the former gentle- 
man, and though his interposition came too late to permit of the 
enlargement as early in the year as had been purposed, and the 
amount allowed was reduced to $1,400, the result was substantial 
and gratifying. Altogether the accommodations provided through 
the expenditure allowed have reached 260 beds of the 300 planned, 
the capacity of the camp for convalescent working patients having 
been doubled and an entirely new camp for patients from the acute 
hospital service and containing 40 beds has been established. 
The details of the year's experience are related, as in the reports of 
the two preceding years, by the several members of the medical 
staff who have had individual charge of these camps in subsidiary 
reports which follow this section. 

It is hoped that the facts presented, the deductions therefrom 
which are thought to be unmistakable and the approval which has 



Manhattan State Hospital, East, Ward's Island. 23 

been expressed by qualified outside observers, will lead to generous 
provision for such further operations as my successor may see fit to 
inaugurate. To this end the sum of $3,000 is included in the 
preliminary list of recommended improvements appearing in this 
report. 

The aggregate outlay for tents and appurtenances during the four 
years of the hospital's trial of the camp system has been $3,500. 

NOTES ON CAMP A 

C. Floyd Haviland, M. D., Assistant Physician 
The experience of the third year of camp treatment of the tuber- 
culous insane at the Manhattan State Hospital, East, has again 
demonstrated the value of the method for this doubly unfortunate 
class of patients. 

During the hospital year from October 1, 1903, to October 1, 
1904, 83 patients have received treatment, the movement of popu- 
lation in Camp. "A" having been as follows: 

Patients in camp October 1, 1903 41 

New cases admitted 42 

Total number treated 83 

Patients died 23 

Patients discharged from hospital 4 

Patients transferred to wards and remaining there 12 

39 

Patients in camp October 1, 1904 44 

Nine patients were admitted to the camp as suspected cases of 
phthisis and are included in the above number in whom it was 
impossible to definitely diagnose the disease. One other such patient 
remained in the camp October 1, 1903, so that there are 10 patients 
to be excluded in the table showing the movement of the camp 
population, if only the undoubtedly tuberculous patients are con- 
sidered. Seven of these patients were re-transferred to the wards, 
one was discharged from the hospital, while two are still under 
observation on October 1, 1904. 

The following table shows the movement of population in the 
camp, considering the undoubted phthisical patients alone: 

Patients in camp October 1, 1903 40 

New cases admitted 33 

Total number treated 73 



24 Ninth Annual Report of the 

Patients died 23 

Patients discharged from hospital 3 

Patients re-transferred to wards and remaining there 5 

31 

Patients in camp October 1, 1904 42 

The 10 questionably tubercular patients are excluded in all of 
the subjoined statistics, the undoubtedly phthisical patients alone 
being considered. 

The three phthisical patients discharged, not only showed suffi- 
cient physical improvement to warrant the belief that the disease 
process was permanently arrested, but they were also recovered 
mentally. 

Of the five patients re-transferred to the wards, in whom the 
disease remains inactive October 1, 1904, the following are the 
periods of time since each has been removed from camp treatment: 
11 months, 11 months, 1 month, 4 months, 1 month. Average, 
5 months, 19 days. 

Considering the total number of phthisical patients treated, the 
eight cases discharged and re-transferred afford 10.96 per cent 
in whom the disease is apparently permanently arrested. Exclud- 
ing those who died, and who, in the majority of cases, were far 
advanced in the disease when admitted and offered little hope for 
improvement, a percentage of 16 is established in whom the tuber- 
cular process has been rendered inactive during the past year. This 
percentage is approximately the same as that of previous years of 
the camp's existence, and while it may not appear large, it should 
be remembered that these consumptives suffer also from the most 
varied forms of mental alienation, which in many cases tend to aggra- 
vate the tubercular process. In a large number also the disease 
is in an advanced stage when the patient is received for treatment. 

The majority of those who died were thus advanced in pulmonary 
tuberculosis when admitted, and the following shows the period of 
camp residence of the 23 cases which resulted in death: 

Under 1 month 10 

Between 1 and 2 months 4 

Between 3 and 4 months 1 

Between 8 and 9 months 2 

Between 10 and 1 1 months 1 

Over one year 5 

23 



Manhattan State Hospital, East, Ward's Island. 25 

The five patients who died after a camp residence of over one 
year should be excluded from the list of deaths from phthisis, as in 
each case death was the direct result of a complicating disease, the 
tubercular process being entirely inactive in four of them and in 
the fifth acting but as a contributory cause of death. One patient 
suffered from chronic interstitial nephritis, one from chronic endo- 
carditis, one from acute enteritis and arterio-fibrosis, one from 
status epilepticus, while the fifth- case suffered from coxalgia as well 
as pulmonary tuberculosis. 

The weight on admission of the patients who died also demon- 
strates their reduced physical condition when coming under camp 
treatment, 10 weighing less than 100 pounds when admitted. 

The following is a summary of these weights on admission to the 
camp: 

Between 80 pounds and 90 pounds . . 5 

Between 90 pounds and 100 pounds 5 

Between 100 pounds and 110 pounds 3 

Between 110 pounds and 120 pounds 6 

Between 120 pounds and 130 pounds 3 

Between 130 pounds and 140 pounds 1 

23 



The greatest weight was 135 pounds; the least weight was 82 
pounds, while the average of all the patients who died was but 
105.48 pounds. 

Excluding the five patients who died of intercurrent diseases, and 
thus considering only the 18 patients whose death resulted 
directly from phthisis, a phthisical death rate of 8.1 per cent is 
established for the hospital and a rate of 24.65 per cent on the 
number of phthisical patients treated. These percentages show but 
little change from those established in previous years of the camp 
treatment, although for three months the hospital received no pa- 
tients, the total admissions for the year being thereby decreased by 
approximately 100 patients and the total number of deaths in the 
hospital being decreased by about 40. 

The phthisical death rate in 1891, 10 years previous to the inaugu- 
ration of the camp treatment, was 17.8 per cent of the total number 
of deaths, but with increasing care in the treatment of these patients 
the phthisical death rate was reduced to 9.8 per cent of total deaths 
in 1900, the year previous to the establishment of the tent system, 
the average death rate during the entire 10 years previous being 



26 Ninth Annual Report of th^ 

14.1 per cent. With the establishment of the camps in 1901, the 
phthisical death rate was, however, still further reduced to 8.8 per 
cent. In 1902, the second year of their existence, a rate of 8 per 
cent was established, so that the rate of 8.1 per cent the past year, 
while showing an infinitesimal increase, is in reality equally favorable 
when there is considered the increased number of cases admitted 
in an advanced state of the disease shown in the above statistics. 

Twenty-four patients remained in the camp October 1, 1904, who 
had been under continuous treatment throughout the year and the 
majority of these had been camp patients for still longer periods 
varying from one year to three years and four months. The follow- 
ing shows the variation in weights of these patients since their 
admission to the camp: 

Sixteen have gained in weight, seven have lost in weight, and one 
weighed the same October I, 1904, as when admitted to the camp 
a year ago. 

Greatest individual gain 31 lbs. 

Smallest individual gain 1 lb. 

Average gain 13.9 lbs. 

Greatest individual loss 25 . 5 lbs. 

Smallest individual loss 2 lbs. 

Average loss 9 . 92 lbs. 



In addition to the above number there remain 26 patients who 
were under camp treatment for but a part of the year, including 
the three cases discharged from the hospital and the five who were 
transferred to the wards. The greatest number of those patients 
who were discharged and transferred had, however, an aggregate 
camp residence of over a year, having been continuously under 
treatment for various periods prior to October 1, 1903. Excluding, 
therefore, those eight patients, the following is a summary of the 
gain and loss in weight of the remaining 18 patients, arranged as 
regards their periods of camp residence: — 

Number 
Period of residence of patients Gained Lost 

Under 12 months 1 19 lbs. 

Under 11 months 2 \ 19 ^ s ' 

1 21 lbs. 

Under 10 months 1 32 lbs. 

Under 8 months 1 28.5 lbs. 

Under 7 months 1 39 lbs. 



Manhattan State Hospital, East, Ward's Island. 



27 



Period of residence 

Under 6 months. 

Under 5 months. 

Under 4 months. 

Under 3 months. 

Under 2 months. 

Under 1 month . . 



Number 

of patients 


Gained 


Lost 


2 

1 

3 


3.5 lbs. 

2.5 lbs. 
j 8.5 lbs. I 
111 lbs. f 


1 lb. 
9 lb. 


2 
3 
1 


2 lbs. 
( 3 lbs. 
< 14.5 lbs. 

( One unchan 

3 lbs. 


7.5 lb. 
ged 


18 Average gain A\> 
14.5 lbs. 


erage loss, 
5.83 lbs. 



It is thus seen that while 14 patients of this number gained 
in weight, only three lost weight, while one weighed the same at the 
-end of two months' treatment as upon admission. 

Summarizing, in a like manner, the discharged and transferred 
patients, it is seen that all showed a marked increase in weight, 
considering the whole period of camp treatment, in some instances 
this increase being of a remarkable character. 

Period under treatment Gained 

2 years, 1 1 months 16 lbs* 

2 years, 7 months 42 . 5 lbs. 

1 year, 7 months 26 lbs. 

1 year, 5 months 74 lbs. 

1 year, 1 month 83 lbs. 

7 months 50 lbs. 

3 months 23 lbs. 

3 months 14 lbs. 

Average gain : 41.06 lbs. 



And not all of the above were incipient cases of phthisis on admis- 
sion, as is shown by their weights when admitted. These weights 
were as follows: 

Eighty-three pounds, 90 pounds, 93.5 pounds, 103 pounds, 
123 pounds, 126 pounds, 145 pounds, and 152 pounds. 

The first of the above patients doubled his weight in 13 months, 
weighing 166 pounds when transferred; the second gained 74 pounds 
in 17 months; the third 26 pounds in 19 months and the fourth 23 
pounds in three months. In none were there any symptoms of an 



28 Ninth Annual Report of the 

active phthisical process when leaving the camp and in none of them 
transferred to the wards has there been any reappearance of such 
symptoms. 

Excluding only those patients who died and such non-tubercular 
patients as were under temporary observation in the camp, thus 
combining those under treatment for but a part of the year and 
those who were camp patients throughout, the following shows the 
results as regards gain and loss of weight among them, considering 
in each case the whole period of camp residence: 

Gained in weight 38 

Lost in weight 10 

Remained unchanged 2 

50 



Greatest individual gain 83 lbs. 

Smallest individual gain 1 lb. 

Average gain 19 . 84 lbs. 



Greatest individual loss 25 . 5 lbs. 

Smallest individual loss 1 lb. 

Average loss 8 . 69 lbs. 



As regards the 23 patients who died, 18 of them showed a steady, 
progressive physical failure with accompanying loss in weight until 
death occurred. As previously stated, five had. however, shown 
an improvement as regards the phthisical process, with a concomitant 
gain in weight, but, after the development of a complicating disease, 
these, too, steadily lost weight until death ensued. 

An innovation of the past year has been the construction of small 
revolving tents, so placed upon a base with rollers between that 
they may be turned to face any direction, so affording the patients 
the benefit of a sun bath during any period of the day, and what 
is equally important, protecting them from the direct force of the 
wind. No patient with a continuous elevation of temperature is 
allowed to take exercise, but such a patient when placed in one of 
these small revolving tents can take his "rest cure" literally out of 
doors, the canvas being left open. One revolving tent has been 
constructed sufficiently large to contain two beds, and thus a means 
is afforded to provide the same advantage for such patients as are 
too weak to use the reclining chairs used in the smaller tents. 



Manhattan State Hospital, East, Ward's Island. 29 

As in the past, the camp treatment for these patients has con- 
tinued uninterruptedly throughout the year, notwithstanding an 
unusually severe winter and despite the changeable character of 
the weather. And the experience of former years has been repeated 
in that it has again been found that the winter months are the most 
favorable for the treatment of tubercular patients, while again were 
the least favorable results obtained in the month of July, with its 
attendant heat, humidity and variability of temperature. 

The statistics as given, again demonstrate the success which has 
attended the camp treatment of the tuberculous insane at the Man- 
hattan State Hospital, East. While symptomatic medicinal treat- 
ment is employed when indicated, the chief reliance in treatment 
continues to be placed mainly upon the open air life in tents, the 
benefit of which is given to every patient in the hospital presenting 
symptoms of an active phthisical process. 

TABLE OF GENERAL STATISTICS, 

Camp for Tubercular Patients. For a Period of 366 Days, 

October 1, 1903, to October 1, 1904 

Capacity of camp 44 

Number of patients admitted. 83 

Number of patients discharged 4 

Number of patients retransf erred to wards ' 12 

Number of patients died 23 

Numper of patients out for daily exercise (average) 24 

Number of patients confined to bed (average) 20 

Number of patients on daily medication (average) 25 

Number of patients improved — 

(a) Physically 48 

(b) Mentally 30 

(c) Discharged from camp 16 

Percentage discharged 4. 81 

Percentage retransf erred to wards 14.45 

Percentage died 27 . 71 

Percentage out for daily exercise (average) 54 . 54 

Percentage confined to bed (average) 45 . 45 

Percentage on daily medication (average) 56.81 

Percentage improved — 

(a) Physically 57.83- 

(b) Mentally 36. 14 

(c) Discharged from camp 19 . 27 



30 Ninth Annual Keport of the 

Percentages are based on total number of patients admitted, except 
average percentages, which are based on average census of camp. 

NOTES ON CAMP B 
Arthur M. Phillips, M. D., Junior Physician 

The open-air treatment of the demented class of insane having 
proven its value during the past three years, the camp was reopened 
as usual on June 1, 1904. 

It was occupied by 44 patients, all of whom were demented and 
a majority extremely untidy. There were 10 bed cases, several 
advanced cases of paresis scarcely able to walk, and many cases 
quite weak physically. 

With the exception of one advanced case of paresis, all the patients 
showed during their camp residence a decided physical improvement, 
and in several cases there was a marked mental improvement, shown 
by interest taken in their surroundings, their employing themselves 
in a useful manner about the camp and becoming more cleanly in 
their personal appearance and habits and able to answer questions 
with a fair degree of intelligence. 

Of the 51 patients treated in the camp during the period of four 
months from June 1 to October 1, 1904, only one died, and he was 
bedridden and in the advanced stage of paresis upon entering the 
camp. Of the 10 bed patients, only five still remain in bed. 

On account of their tendency to wander away, a few cases were 
retransferred to the wards and weak patients received in their places, 
so that the total number of patients treated was 51. 

Several ulcers of the legs which had resisted treatment while the 
patients were indoors, after a few weeks of outdoor treatment, 
improved materially and ultimately healed kindly. With the excep- 
tion of three patients, all gained in weight, the particulars being as 
follows: 

Greatest individual gain in weight shown 65 lbs. 

Smallest individual gain in weight shown 1 lb. 

Average gain in weight shown 13 . 9 lbs. 

Greatest individual loss shown 5 lbs. 

Smallest individual loss shown 1 lb. 

Average loss shown 2.33 lbs. 

The patient who showed the greatest gain, on admission to the 
camp, weighed 100 pounds. He refused at that time to speak, eat, 



Manhattan State Hospital, East, Ward's Island. 31 

or care for himself in any manner, and required artificial feeding. 
After a few weeks of tent life he began to eat and soon improved suffi- 
ciently to be up and about the camp. With this physical improve- 
ment he showed decided mental improvement, becoming cleanly, 
employing himself, conversing in an intelligent manner, and he is 
at present an industrious worker about the camp. 

On the whole, the open-air treatment this year, as in previous years, 
seems to have maintained its sphere of usefulness in the care and 
treatment of the chronic insane. 

TABLE OF GENERAL STATISTICS 

Camp for Demented Patients. For a Period of 122 Days, 
June 1 to October 1, 1904 

Capacity of camp 44 

Number of patients admitted 51 

Number of patients discharged 

Number of patients died 1 

Number of patients transferred to wards : 6 

Number of patients out for daily exercise (average) 36 

Number of patients confined to bed (average) 8 

Number of patients on daily medication (average) 8 

Number of patients improved — 

(a) Physically 50 

(b) Mentally 8 

(c) Discharged from camp 

Number of patients employed in camp ward work (average) .... 8 

Percentage discharged 

Percentage died ; . 2 

Percentage transferred to wards 14 

Percentage out for daily exercise (average) 82 

Percentage confined to bed (average) 18 

Percentage on daily medication (average) 18 

Percentage improvement — 

(a) Physically 97 

(b) Mentally 18 

(c) Discharged from camp 

Percentage of patients employed 18 



Percentages are based on total number of patients admitted, except 
average percentages, which are based on average census of camp. 



32 Ninth Annual Report of the 

NOTES ON CAMP C 
P. C. Washburn, M. D., Junior Physician 

The camp for decrepit female patients was reopened on June 1 
of this year on the site used in previous years. The summer, espe- 
cially the month of July, was characterized by a number of sultry, 
rainy days, but, notwithstanding this disadvantage, the results of 
open-air treatment this year were very satisfactory. The patients 
were mostly feeble old women, 14 of them being above the age of 70 
and only six below the age of 45. All except two of the women gained 
in weight, the greatest individual gain being 35 pounds; the least 
one pound, and the average nine and one-tenth pounds. Two 
patients lost in weight; one eight pounds and the other one pound. 

There were no deaths in the camp and but few cases of sickness ; 
fewer relatively than in the wards. One woman who began her 
camp life with severe cough and expectoration, poor circulation, as 
shown in cyanotic condition of extremities and lips, some indigestion 
and general emaciation and debility, has now a good appetite, im- 
proved circulation and has gained seven pounds, a steady though 
gradual gain being maintained. 

The mental stimulus of the fresh air and agreeable surroundings has 
been noticeable. The patients after a few weeks in the camp seemed 
to take a new interest in their surroundings as their attention was 
attracted by the passing events of outdoor life; this mental awakening 
was shown in some cases by a marked improvement in habits formerly 
untidy. 

No patients were discharged. Of the 44 occupants of the camp, 
eight, or about 16 per cent, were regular workers, and many of the 
others gave slight assistance around the camp. None of the patients 
were confined to bed, and but two were on continued medication. 
Every patient took exercise or at least sat outdoors regularly every 
day. 

On the whole, we may conclude that for another season the camp 
for women has proven its value and added to the comfort and general 
health of the patients. 

The camp still continues in operation on the date of this report, 
and the expectation is that it will remain so during the autumnal 
months. 

Table showing ratio between — 

(a) Lowest individual gain in weight, 1 lb. = as 1 (lowest). 

(b) Highest individual gain in weight, 35 lbs. = as 35 (highest). 

(c) Average individual gain in weight, 9.1 lbs. = as 9.1 (average). 

1 :35 :9.1. 



Manhattan State Hospital, East, Ward's Island. 33 

The average weight on June 1 was 102.63 pounds. 
The average weight on October 1 was 111.73 pounds. 

TABLE OF GENERAL STATISTICS 

Camp for Female Patients. For a Period of 122 Days, June 1 
to September 30, 1904 

Capacity of camp 44 

Number of patients admitted 51 

Number of patients discharged 

Number of patients died 

Number of patients transferred to wards 7 

Number of patients out for exercise (average) 44 

Number of patients confined to bed (average) 

Number of patients on daily medication (average) 2 

Number of patients improved— 

(a) Physically 33 

(b) Mentally 4 

(c) Discharged from camp 

Number of patients employed in camp 8 

Percentage discharged 

Percentage died 

Percentage transferred to wards 13 . 72 

Percentage out for exercise (average) 100 

Percentage confined to bed (average) 

Percentage on daily medication (average) 3 . 92 

Percentage improvement — 

(a) Physically 64. 70 

(b) Mentally ■ 7.84 

(c) Discharged 

Percentage employed in camp 15 . 68 

Percentages are based on total number of patients admitted, except 
average percentages, which are based on average census of camp. 

Greatest individual gain in weight 35 lbs. 

Least individual gain in weight 1 lb. 

Average individual gain in weight 9.1 lbs. 

Total number of individuals gaining weight throughout the 

summer 49 

Greatest individual loss in weight 8 lbs. 

Least individual loss in weight , 1 lb. 

Total number of individuals losing weight , 2 



34 Ninth Annual Report of the 

NOTES ON CAMP D 
Frank H. Magness, M. D., Assistant Physician 

This camp was established in May, 1903, for the outdoor treatment 
of those patients who are employed during the day at sedentary 
occupations, and proved so successful that it was reopened on the 
first day of May, 1904, with a capacity of 84 patients of the indoor 
working class, being an increase of 40 patients over the population 
of the camp in 1903. 

Of the patients in this camp 16 are employed in the shoe shop; 
10 in the printing shop; 16 in the tailor shop; 15 in the kitchens; 12 
in the laundry; 11 in the bakery; two in the tin shop; and two in 
the storerooms. 

The improvement both in the mental and physical condition, of 
the patients was marked from the beginning; they began to gain in 
weight, and in some cases that had shown a retarded convalescence 
improved so much that two patients were discharged and eight 
other patients are now under recommendation for discharge. 

The camp was supplied with all kinds of outdoor games and on 
pleasant evenings the patients availed themselves of the opportunity 
for recreation by playing baseball, football, croquet, lawn bowls, 
golfette outdoors, or the usual ward games, cards, checkers and 
dominoes, varied by reading magazines, papers and books from the 
hospital library according to their inclination. 

Not one of the patients took advantage of the liberty accorded 
to attempt elopement, and all seemed to appreciate the benefit 
derived from the freedom of outdoor life. 

The beneficial effects of life in the open air are proven by the fact 
that only two patients out of the entire 84 have been on continued 
medication during the period of camp life, and furthermore the 
improvement in the mental condition of the patients in the camp 
has been general, those patients who were depressed have become 
much more cheerful, delusions are not so pronounced and hallucina- 
tions are fading. 

In 53 patients there has been an increase in bodily weight; in 18 
patients the bodily weight has remained stationary; in 13 patients 
there has been a slight loss in bodily weight. The changes have 
been as follows: 

Greatest individual gain in weight shown 65 lbs. 

Smallest individual gain in weight shown 5 lbs. 

Average gain in weight shown 6 . 67 lbs. 

Greatest individual loss in weight shown 5 lbs. 

Smallest individual loss in weight shown 1 lb. 



Manhattan State Hospital, East, Ward's Island. 35 

Having demonstrated the beneficial effects of outdoor life for 
patients during the summer weather, it has been decided to maintain 
the camp throughout the following months of autumnal weather. 

TABLE OF GENERAL STATISTICS 

Camp D. For a Period of 122 Consecutive Days, June 1 to 
September 30, 1904 

Capacity of camp 84 

Number of patients admitted 84 

Number of patients discharged 2 

Number of patients out for daily exercise 84 

Number of patients on daily medication 2 

Number of patients improved — 

(a) Physically 84 

(b) Mentally 84 

(c) Improved and under consideration for discharge. ... 8 

(d) Improved and discharged 2 

Number of patients employed 84 

Occupations — 

(a) Printers 10 

(b) Shoemakers 16 

(c) Tailors . 16 

(d) Cooks ' 15 

(e) Laundrymen 12 

(f) Bakers. .....'. , 11 

(g) Tinsmiths 2 

(h) Storeroom workers 2 

Percentage discharged 2 . 38 

Percentage on medication 2 . 38 

Percentage improvement — 

(a) Physically ' 100 

(b) Mentally 100 

(c) Improved and under consideration for discharge 10 

(d) Improved and discharged 2 . 38 

Percentage employed 100 

Percentage — 

(a) Printers 12 

(b) Shoemakers 19 

(c) Tailors 19 

(d) Cooks 18 

(e) Laundrymen 14 

(f) Bakers • 13 



36 Ninth Annual Report of the 

(g) Tinsmiths 2 . 38 

(h) Storeroom workers 2 . 38 

Percentages are based on total number of patients admitted, 

except average percentages which are based on average census of 

camp. 

NOTES ON CAMP E 

John Rudolph Knapp, M. D., Assistant Physician 

Not the least among the features which conduce to the improve- 
ment of patients, both mentally and physically, in the Manhattan 
State Hospital, East, Ward's Island, is the tent system originally 
instituted as a therapeutic measure for the tuberculous insane. 

It had proven so beneficial in this connection as to commend 
outdoor treatment as of possible value for patients not the subjects 
of tuberculosis. On the strength of this conjecture, three additional 
camps were instituted in former years and the results attained 
amply justified their establishment. 

The system now comprises five camps, the last one having been 
opened July 1, 1904, as an adjunct to the service in the hospital 
wards. It has accommodations for 44 beds, and is designated 
Camp E. 

The patients are those of the feeble and bedridden type, who in 
addition to their mental affection suffer from such bodily diseases 
as gastro-enteritis, locomotor ataxia, chronic endocarditis, mul- 
tiple sclerosis, epilepsy, etc., the only exception being those patients 
who have been up and about the camp and have assisted with the 
work since its incipiency. 

After observing the changes wrought in the majority of these 
patients after a three months' residence in the camp, one is led to 
recognize that it is not alone in the improvement of patients who are the 
unfortunate subjects of tuberculosis that camp life during the warmer 
season of the year, finds its place as a therapeutic measure. Its 
associate benefits accrue to a large class of the chronic insane, as well 
as to those acute cases who happily pass on to recovery and discharge, 
the latter being exemplified in a case of acute melancholia, who, 
although bedridden and suffering from chronic cardiac disease at the 
time the camp was established, has since steadily improved, both 
mentally and physically, having gained 35 pounds in weight. He 
is now recovered from his mental affection and has been recommended 
for discharge. 

The following data are worthy of note: 

Out of a census of 44, a gain in weight occurred in 23 (51.11 per 
cent) of the patients, 35 pounds being the highest individual gain, 



Manhattan State Hospital, East, Ward's Island. 87 

while one pound was the lowest, and eight pounds the average. Of 
the remainder, seven patients registered a loss of weight, the greatest 
individual loss being nine pounds, the smallest two pounds, an average 
of three and seven-tenths pounds; 13 patients showed no change in 
weight, and one patient died, being an advanced case of paresis with 
chronic cardiac disease. 

When the camp was first organized there were 32 patients confined 
to bed, and 12 who could move about and take advantage of the 
greensward as an exercise ground, four being helpers assisting with 
camp work. 

October 1, after three months, there were but 22 patients confined 
to bed, and the number who were up and about had been augmented 
to 22, a notable gain. 

The outdoor life has had an appreciable effect in that the patients 
are as a rule less depressed, take a greater interest in their surround- 
ings, and are correspondingly improved in their general nutrition. 
Considering the amount of unfavorable weather during the last three 
months, the above record of improvement in this class of patients 
has been especially gratifying, and the results show that camp life 
is beneficial to certain acute cases, as well as to those of the chronic 
type. 

The following table shows the general statistics of the camp for the 
period referred to above: 

TABLE OF GENERAL STATISTICS 

Camp E. For a Period of 92 Consecutive Days, July 1 to 

October 1, 1904 

Capacity of camp 44 

Number of patients admitted 45 

Number of patients discharged 

Number of patients died 1 

Number of patients out for daily exercise 22 

Number of patients bedridden 22 

Number of patients on daily medication 21 

Number of patients improved — 

(a) Physically 23 

(b) Mentally 1 

(c) Improved and under consideration for discharge 1 

(d) Improved and discharged 

Number of patients employed 4 

Percentage discharged 

Percentage died 2 . 22 



38 Ninth Annual Report of the 

Percentage out for daily exercise 50 

Percentage bedridden 50 

Percentage on daily medication 47 . 72 

Percentage improvement — 

(a) Physically 51 . 11 

(b) Mentally : 2.22 

(c) Under consideration for discharge 2 . 22 

(d) Improved and discharged 

Percentage employed 8 . 88 



Percentages are based on total number of patients admitted, except 
average percentages, which are based on average census of camp. 

MEDICAL STAFF 

The staff of consulting physicians and surgeons of the hospital 
hasjbeen added to during the year by the return of Dr. Frederick 
Peterson and the appointment of Dr. Charles E. Quimby. 

After serving for several years as a member of the board, Dr. Peter- 
son thought it best to retire in view of his acceptance of the position 
of medical member and president of the State Commission, lest his 
double relation to the hospital might occasion criticism or embarrass- 
ment. With his regretted relinquishment of the commissionership 
during the current year, the possible objection was, of course, re- 
moved and his return to his former relation as consultant followed. 
Dr. Quimby's experience and recognized prominence in the study 
and treatment of pulmonary diseases will make his services of great 
value, especially in connection with the development in progress at 
the hospital of new methods of caring for the tuberculous insane. 

The remaining change in the consulting board results from the 
resignation, on September 23, 1904, after 17 years of service of one 
of its earlier memebrs, Dr. Walter R. Gillette. Throughout his long 
connection with the hospital Dr. Gillette has been ready both in 
action and counsel, and the writer is glad to avail himself of the 
opportunity of this final report upon the date of his own retirement, 
almost concurrent with that of Dr. Gillette, to make acknowledgment 
of the latter's most valuable aid and support in the trying and per- 
plexing duties of administration. To the vacancy created by Dr- 
Gillette's resignation, his son, Dr. Curtenius Gillette, has been 
appointed by the Commission, upon the nomination of the super- 
intendent. 

Changes in the personnel of the resident medical staff, during the 
year have been as follows: 



Manhattan State Hospital, East, Ward's Island. 39 

Resignations 

Assistant physician: 
Arthur B. Wright, M. D., October 31, 1903. 

Junior physicians: 
Alton L. Smiley, M. D., December 21, 1903. 
Frank L. Grosvenor, M. D., March 16, 1904. 

Promotions 
Junior physician: 
James M. Parkinson, M. D.,from medical interne, June 20, 1904. 

Appointments 

Medical internes: 
James M. Parkinson, M. D., October 12, 1903. 
Frank R. Haviland, M. D., October 15, 1903. 
Alfred J. Fox, M. D., March 4, 1904. 

Junior physicians: 
Philip C. Washburn, M. D., March 31, 1904. 
Arthur M. Phillips, M. D., April 1, 1904. 

Assistant physician: 
Frank H. Magness, M. D., April 25, 1904 (transferred from 
Manhattan State Hospital at Central Islip). 

Transfer 
Junior physician: 
Chester L. Carlisle, M. D., March 18, 1904, to Willard State 
Hospital. 

ACKNOWLEDGMENTS 

The hospital is again indebted for a supply of reading matter, 
collected and forwarded from time to time, to the Hospital Book 
and Newspaper Society. Individual gifts for which grateful acknowl- 
edgments are also made have come from: 

Lotos Club, Mrs. Eleonora Kinnicutt, 39 East Thirty-fifth street, 
Mrs. A. E. Macdonald, Ward's Island. 

From the former source of supply newspapers have been furnished 
to the several wards, and from all sources some valuable ad- 
ditions of bound books have been made to the circulating library 
of the hospital, and a large assortment of current magazines, illus- 
trated periodicals, etc., have been placed upon the ward tables. 

The report of the superintendent in his capacity as treasurer of 
the hospital, as required by law, is also herewith respectfully 
submitted. 

Very respectfully 

A. E. MACDONALD 

Superintendent 



40 Ninth Annual Report of the 



REPORT OF THE TREASURER OF THE MANHATTAN STATE 

HOSPITAL, EAST, FOR THE FISCAL YEAR ENDING 

SEPTEMBER 30, 1904 

GENERAL FUND 

Receipts 

Balance on hand October 1, 1903 $1 ,059 12 

From State treasury for maintenance on estimates 1 

to 12, inclusive 346,607 40 

From reimbursing patients • 7 ,951 76 

From all other sources 478 21 

Total receipts for maintenance $356,096 49 

Expenditures 

Estimate No. 1. For salaries $19,881 84 

Estimate No. 2. For wages 112,810 47 

Estimate No. 3. For provisions and stores 125,531 93 

Estimate No. 4. For ordinary repairs 8 , 529 89 

Estimate No. 5. For farm and grounds 4,747 99 

Estimate No. 6. For clothing 17,942 77 

Estimate No. 7. For furniture and bedding 10,637 22 

Estimate No. 8. For books and stationery. 2,930 01 

Estimate No. 9. For fuel and light 25,384 13 

Estimate No. 10. For medical supplies 2,484 24 

Estimate No. 11. For miscellaneous expenses 9,291 22 

Estimate No. 12. For transportation of patients 135 55 

Remitted to State treasurer 7 , 382 76 

Balance on hand September 30, 1904 8,406 47 

Total expenditures during year $356,096 49 



SPECIAL FUND 

Receipts 
Total receipts from State Commission in Lunacy for 

extraordinary improvements $20,684 40 



Expenditures 
Total disbursements during year for extraordinary 
improvements under apportionments by State Com- 
mission in Lunacy $20,684 40 



Manhattan State Hospital, East, Ward's Island. 41 

GENERAL MANUFACTURING FUND 

Receipts 

Balance on hand October 1, 1903 $4,301 28 

Total receipts from manufacturing fund .... 10 , 157 51 



$14,458 79 



Expenditures 

Total disbursements during year $10,762 15 

Balance on hand September 30, 1904 3,696 64 



$14,458 79 



Very respectfully 

A. E. MACDONALD 

Treasurer 

PRINTING OFFICE REPORT FROM OCTOBER 1, 1903, TO 
SEPTEMBER 30, 1904 

Manhattan State Hospital, East: 

Forms — State hospital series 212,293 

Envelopes, all kinds 47 , 700 

Passes, steamer, ferry, ward and visitors .... 69 , 500 

Pads, assorted sizes 3,474 

Cards, labels, indexes and reports 11 , 100 

Notices, admission, transfer, sick, etc 6,050 

Slips, cut copying paper, etc 44, 400 

Report books 5 

Official handbooks 15 

294,537 

Manhattan State Hospital, West: 

Forms — State hospital series 76 , 608 

Envelopes, all kinds 31 ,300 

Passes, steamer and ferry 5,000 

Clinical notes 3 , 000 

Notices, slips, orders, blanks and cards. . . . 18,806 
Labels, tags, copying paper, checks, pro- 
grammes 10,400 

Training school calendars 250 

Postal cards, printed 12 , 402 

Report books re-bound 3 

Laundry books 25 

Official handbooks for 1904 12 

157,806 



42 Ninth Annual Report of the 

Manhattan State Hospital, Central Islip: 

Forms — State hospital series 148,800 

Envelopes, all kinds 12,000 

Cards, slips, pads and letter-heads ■ 2,068 

Storekeeper's way-bills, programmes and 

quotation sheets 7 , 100 

Notices, statements, orders and receipts.. . . 1 ,600 

Laundry books, postal cards and calendars . 775 

Official handbooks for 1903 and 1904 24 

Long Island State Hospital, Kings Park, N. Y. : 

Forms — State hospital series 335,350 

Envelopes, all kinds 3 , 000 

Letter-heads 4, 700 

Labels, calendars, slips, blanks, reports, re- 
quisitions, coyping paper and cards 28 , 700 

Official handbooks for 1904 36 

Long Island State Hospital, Flatbush, Brooklyn, 
N. Y.: 

Forms — State hospital series 123 , 325 

Envelopes, all kinds 1 , 100 

Cards, tags, slips, blanks, reports and pro- 
grammes 6 , 700 

Official handbooks for 1904 12 

Willard State Hospital, Willard, N. Y.: 

Forms — State hospital series 67 , 100 

Envelopes, all kinds 4,500 

Official handbooks for 1904 18 

Purchasing Steward's Department: 

Envelopes and postal cards 2,200 

Vouchers, cards, estimates and notices 17,210 

Proposals 28,500 



172,367 



371,786 



131,137 



71,618 



47,910 



Manhattan State Hospital, East, Ward's Island. 43 

Manhattan State Hospitals, General Administra- 
tion: 

Legal blanks, notices, covers, etc 3,500 

Pathological Institute : 

State treasurer's receipts K . 500 

Official handbooks for 1903 3 

503 

American Medico-Psychological Association: 
Envelopes 1,000 

Letter-heads 1 , 500 

2,500 

Binghamton State Hospital, Binghamton, N. Y. : 
Pads 12 

Official handbooks for 1904 10 

22 

St. Lawrence State Hospital, Odgensburg, N. Y. : 
Official handbooks for 1904 6 

Utica State Hospital, Utica, N. Y. : 
Official handbooks for 1904 10 

Buffalo State Hospital, Buffalo, N. Y.: 
Official handbooks for 1904. .' 10 

Gowanda State Hospital, Gowanda, N. Y. : 
Official handbooks for 1903 and 1904 24 

Hudson River State Hospital, Poughkeepsie, N. Y. : 
Official handbooks for 1904 2 

River Crest Sanitarium, Astoria, L. I.: 
Official handbooks for 1904 1 

State Commission in Lunacy, Albany, N. Y. : 
Official handbooks for 1903 and 1904 204 

Rochester State Hospital, Rochester, N. Y. : 
Official handbooks for 1903 10 

Middletown State Hospital, Middletown, N. Y.: 
Official handbooks for 1903 10 

Matteawan State Hospital, Fishkill Landing, N. Y. : 
Official handbooks for 1903 2 

Rulings 
State forms and various rulings 249 , 900 

Summary 

Printed matter 1,353,965 

Rulings 24^,900 

Grand total 1,603,865 



44 Ninth Annual Keport of the 

MATSHOP REPORT OF ARTICLES MADE AND REPAIRED 
FROM OCTOBER 1, 1903, TO SEPTEMBER 30, 1904 

Manufactured 

Aprons 24 

Baseball bases 3 

Brooms 1,788 

Brooms, whisk 168 

Baskets, waste 21 

Baskets, clothes 2 

Brush mats, single, 18 inches by 30 inches, 9 pounds 18 

Brush mats, double, 20 inches by 48 inches, 16 pounds .... 4 

Brush mats, extra large, 24 inches by 72 inches, 34 pounds. 3 

Brush mats, extra large, 32 inches by 75 inches, 44 pounds. 1 

Brushes, bath 11 

Brushes, dust 38. 

Brushes, hair 3 

Brushes, nail 61 

Brushes, shoe 77 

Brushes, scrub , 370 

Brushes, floor 51 

Carpets, laid 6 

Carpets, stair, laid 2 

Crash, stair, laid 2 

Chairs, upholstered 6 

Chairs, caned 574 

Can mats 24 

Cloth mats, single, 18 inches by 30 inches 53 

Cloth mats, double, 18 inches by 56 inches 8 

Coir mats, single, 18 inches by 30 inches, 4 pounds 287 

Coir mats, double, 18 inches by 56 inches, 7 pounds 91 

Coir mats, extra large, 34 inches by 46 inches, 13 pounds 

each ' 2 

Coir mats, extra large, 30 inches by 84 inches, 19 pounds, 

each 1 

Coir mats, extra large, 32 inches by 41 inches, 10 pounds 

each 1 

Coir matting, laid, pieces 40 

Coir rings 52 

Daubers 72 

Drill clothing bags 116 

Hampers 2 

Head rests, covered 6 



Manhattan State Hospital, East, Ward's Island. 45 

Hospital toilet covers for tent 12 

Letter trays 7 

Manila rope for guy ropes, feet 1,200 

Manila rope for side ropes, feet 1,800 

Manila rope for bottom edge of tents, feet 1,500 

Mattresses 1 f 939 

Mattress ticks . 563 

Pillow ticks 100 

Pillows . . . , . 878 

Piano stools, upholstered 2 

Stretchers, covered 3 

Sofas, upholstered 2 

Tent, round, revolving, five feet in diameter 1 

Tent, square, nine feet square 1 

Tent straps 144 

Window shades. 259 

Repaired 

Archer end board 1 

Baskets, bread 12 

Baskets, waste 6 

Baskets, clothes 11 

Baskets, cover for flower pots 6 

Brush mats, single, 18 inches by 30 inches, nine pounds . 15 

Brush mats, double, 20 inches by 48 inches, 16 pounds. . 13 

Brush mats, extra large, 24 inches by 72 inches, 33 pounds 2 

Carpets, bound 6 

Chairs, upholstered 12 

Cloth mats, single, 18 inches by 30 inches 20 

Cloth mats, double, 18 inches by 56 inches 10 

Coir mats, single, 18 inches by 30 inches : . . 25 

Coir mats, double, 18 inches by 56 inches 15 

Coir matting, re-bound, pieces 50 

Head rests, covered 8 

Hammocks 2 

Lounges 8 

Linoleum trimmed and relaid, piece 1 

Mattress ticks 1 } 200 

Mattress ticks (condemned) 450 

Rugs 4 

Settees 7 

Sofas 4 



46 Ninth Annual Report of the 

Stretchers, covered 2 

Tents, hospital 12 

Tents, hospital, fly 15 

Tents, octagon ' 12 

Tents, square 16 

Tents, wedge 8 

Window shades 332 

TAILOR SHOP REPORT FROM OCTOBER 1, 1903, TO 
SEPTEMBER 30, 1904 

The following were made: 

Coats 1,772 

Vests 902 

Pants 2,233 

Overalls 646 

Mittens 1,318 

Caps 282 

Rubber sheets 368 

Cook's coats 693 

Cook's aprons 542 

Restraining sheets ' 332 

Rubber aprons 38 

Laundry bags 54 

Rubber mittens 112 

Cut shirts 2,711 

Clothing covers 4 

New hats 500 

Canvas coats 19 

Canvas pants 19 

The following were repaired : 

Overcoats 895 

Coats • 4,534 

Vests 1,923 

Pants 4,803 

Caps 14 



Manhattan State Hospital, East, Ward's Island. 47 

ACCOUNT OF REPAIRS AND NEW MATERIAL MANUFAC- 
TURED IN THE EAST BUILDING SEWING-ROOM FROM 
OCTOBER 1, 1903, TO SEPTEMBER 30, 1904 

New material made into wearing apparel 

Rugby shirts '. 2 , 089 

Night shirts 1,131 

Drill shirts . ., 339 

Denim shirts 601 

Gingham dresses 533 

Covert dresses 309 

Percale dresses 45 

Canton flannel petticoats 22. 

Flannel petticoats 384 

Muslin chemises 721 

Elastic garters 50 

Sheets 5,900 

Staff sheets 281 

Pillow cases 3, 058 

Shrouds 247 

Tablecloths 600* 

Dish towels 270' 

Face towels \ } 755 

Hand towels 484 

Bath towels ' 5 } 778 

Roller towels 1 805 

Hospital towels 125 

Staff towels 60 

Pillow ticks 468 

Table napkins 1 } 225. 

Cushions 41 

Ticking aprons 74 

Cook's aprons 920 

Drug store aprons 115 

Gingham aprons 16 

Waiters' aprons „ . 39 

Nightgowns 103 

Surgical aprons 7- 

Golf caps 58 

Neckties 395 

Washstand covers 24 

Waiters' sleeves 101 



48 Ninth Annual Report of the 

Suspenders, pairs 1 , 153 

Hospital bibs 232 

Wearing Apparel Repaired 

Shirts 4,614 

Overalls, pairs ; . . 1 , 016 

Cooks' pants, pairs 547 

Cooks' jackets 346 

Cooks' aprons 1 , 744 

Waiters' aprons 72 

Pillow cases 185 

Laundry bags . . 56 

Table cloths 2,115 

Sheets 190 

Spreads "... 25 



SHOE SHOP REPORT OF ARTICLES MANUFACTURED AND 
REPAIRED FROM OCTOBER 1, 1903, TO SEPTEMBER 
30, 1904 

Manufactured 

Shoes, men's ; pairs 1 , 830 

Shoes, women's; pairs 1 ,425 

Slippers, men's, canvas; pairs 77 

Slippers, women's, dongola; pairs 85 

Razor strops ; dozen 10^ 

Repaired 

Shoes, men's ; pairs 3 , 320 

Shoes, women's ; pairs 960 

Horse collar and harness 1 

Boat oars covered; pair 1 

Furnishing printing office with leather; skins 4 



Manhattan State Hospital, East, Ward's Island. 10 

LAUNDRY REPORT FROM OCTOBER 1, 1903, TO SEPTEM- 
BER 30, 1904 

The total number of pieces laundered during the year was 834,582. 

SOAPMAKER'S REPORT 
The amount of soap manufactured during the year ending Sep- 
tember 30, 1904, was as follows: 

Chip, pounds. 2,700 

Bar, pounds 1 , 320 



ENGINEER'S REPORT 

Run new water supply to top floor of east building. 

Put new w T ire ropes on dumb waiter at dining-room in east build- 
ing. 

Installed two new sinks in basement of center building for drug 
storeroom. 

Changed the heating system of old ward 16 to provide for the 
tailor shop being moved there from the basement under the attend- 
ant's home. 

Installed new steam cooking boiler in main kitchen. 

Installed milk-tester in basement of main building under the 
drug store. 

Installed new closet in toilet room, third floor of east building. 
New basin in basement of east building near linen room. Four 
new cereal boilers in main kitchen. 

New plate warmer installed for use in dining-room at east building. 
New urinal in toilet, ward 21. 

New "Manhattan " steamer installed in main kitchen. 

Run new lines of steam and return pipes, and installed radiators 
and coils for additional heat in ward E, east building. 

Installed new coil in sleeping apartments on first floor, east building. 

Installed three heaters in attendant's rooms in ward 12, main build- 
ing. 

Fitted up bathrooms and toilet on third floor, center building, 
installing two closets, urinal, basin, spray bath, bathtub with sewer 
connections, floor drainage, etc; also steam and return lines and 
coil for heating the room. 

Run new lines of galvanized iron pipe for water supply by the 
"pressure" system, to dispense with the old and unsafe tanks, to 
the pantries, lavatories and toilet rooms in the wards of the main 
building. 

4 



50 Ninth Annual Keport of the 

New radiator for additional heat in northwest room of third floor, 
east building. 

New sink installed in kitchen of east building. 

Run new steam and return lines, new hot and cold water supplies, 
and installed sterlizers, basin and sink and radiators for heating 
new operating-rooms in ward E, east building. 

Installed copper boiler in kitchen of east building. New blow-off 
valves put on steam boilers in main boiler-house. 

New water supply lines put in for exercise grounds and for tank 
at outdoor bath. 

Run steam and return pipes from main boiler-house to new fire- 
engine house, and made and put up two steam coils for heating 
the engine-house, and made necessary steam and return connections 
so that the water in boiler of fire-engine can be kept hot with steam 
from main boiler-house. 

Put up new five-inch iron leader pipe from eave-trough to the 
sewer connections in front of the east building and also in the court 
yard of east building. 

Installed sink in tailor shop in old ward 16 for use of tailor shop 
employees. 

Installed closet and sink with hot and cold water supply, sewer 
connections, etc., for use of patients in camp on north side of hospital. 

Installed new closet and made sewer connections for employees of 
mat shop, in old ward 17. 

Installed new steam kettle in kitchen at the east building. 

Installed new sewer traps and waste connections from bath- 
tubs on second floor of attendants' home. 

Put new wire ropes on car of dumb waiter to wards 1, 5 and 8. 

Put new valve on fire line in basement of main building under 
ward 13. 

Run line of galvanized pipe for pressure system for hot-water 
supply at east building. 

New valve installed in steam line from boiler No. 2 at east build- 
ing boiler-house. 

Installed new four-inch angle valve on supply to hot-water tank 
in main boiler-house. New man-hole over the sewer from wards 
13, 18 and 21. 



Manhattan State Hospital, East, Ward's Island. 51 

TINSMITH'S DEPARTMENT 

Articles manufactured during the year 
Tin 
Made 27 20-gallon cans; 72 six-gallon cans; three 15-gallon cans; 
two 10-gallon cans; 36 two-gallon cans; seven 12-quart cans; 37 
six-quart cans; 95 four-quart cans; 12 three-quart cans; 80 two- 
quart cans; five three-pint cans; 74 dishpans; three soap trays; 
200 chambers; 97 assorted covers; two coffee pots, three sauce- 
pans; 47 assorted dippers; 21 assorted pudding pans; two cake 
pans; seven assorted strainers; two copper strainers; 61 cuspidors; 
108 dustpans; 72 drinking cups; 11 assorted funnels; 48 wash- 
basins; 36 large mess boxes; 84 small mess boxes; six assorted 
boxes; four double oatmeal boilers; six single oatmeal boilers; 
three meat pans; six hand-grenade brackets; four pepper and salt 
boxes; three floor-plates with sleeves; 174 letters and numbers; 
one milk pail, two wash boilers; 96 bed card cases; two collanders; 
four cake turners; three liquid measurers; one marking pot; two 
scoops; one oil can; 42 feet assorted tin pipe; four elbows; 14 tags. 

Galvanized Ironware 
Two 30-gallon cans; six 20-gallon cans; 20 six-gallon cans; 146 
swill buckets; 48 fire buckets; 13 garbage cans; six rubbish cans; 
six covers; four skimmers; three boxes; 27 floor plates; three hot- 
water trays; 12 potato boilers; two radiator covers; four coal 
scuttles; seven drippans; one ventilator; seven switch boxes, 
lined; eight bins, lined; lined wall over sink in east building kitchen; 
lined floor in staff kitchen and pantrys, wards 11 and 3. 

Black Ironware 
Three hundred and four feet stovepipe, assorted; 19 elbows, 
assorted; 15 caps, assorted; three collars; five machine screws; 
seven bolts; one die for shoe hook machine; two tripods; nine 
screw hooks; six bed hooks; 15 tennis hooks; 84 staples. 

Black Ironware 
Made three fire-pots; one stand for sterilizer. 

Russia Ironware 
Six roast pans; 48 bread pans; one stove; 20 feet assorted pipe. 

Zinc Ware 
One negative washer; seven covered drain boards; covered 
kitchen table. 



52 Ninth Annual Report of the 

Brass Ware 
Five floor plates; 259 escutcheons; 32 striking plates; 72 bush- 
ings for locks; 68 model beds; 14 numbers; eight ferrules; one 
strainer; 11 screws; three bolts; two tags; die for eyelet machine; 
14 hooks. 

Copper Ware 

Twelve striking plates; one strainer; two glue pots; one steril- 
izer. 

Miscellaneous 

Four hundred and seventy-one keys; 72 Yale keys; four letter 
files; stamped 312 whistles; stamped 30 pair forks and knives; 
put up stoves in camps, and covered floor under same with sheet 
iron, also removed same again; put up stove and new pipe in new 
tailor shop and covered part of the wall and ceiling with galvanized 
sheet iron; put up new laundry stove and pipe; decorated stand 
and halls for all holiday sports. 

Repaired the following 
Tin Ware 

Twenty-one 20-gallon cans with new bottoms; two 15-gallon cans 
with new bottoms; one 10-gallon can with new bottom; 67 six- 
gallon cans with new bottoms; 38 two-gallon cans with new bot- 
toms; one 30-quart can with new bottom; three 20-quart cans with 
new bottom; two 12-quart cans with new bottoms; three eight- 
quart cans with new bottoms ; six six-quart cans with new bottoms ; 
five three-quart cans with new bottoms; four five-quart cans with 
new bottoms; eight four-quart cans with new bottoms; two two- 
quart cans ; 25 dishpans with new bottoms ; two large mess boxes 
with new bottoms; 12 small mess boxes; four coffee pots with new 
bottoms; 23 20-gallon cans; eight 15-gallon cans; five 10-gallon 
cans; 48 six-gallon cans; 3S two-gallon cans; 10 30-quart cans; 
24 20-quart cans; 13 12-quart cans; 17 eight-quart cans; 38 six- 
quart cans; 13 five-quart cans; 11 four-quart cans; nine three- 
quart cans; 21 two-quart cans; 17 large mess boxes; 110 small 
mess boxes; 14 assorted boxes; 14 dishpans; nine assorted strainers; 
15 watering cans; 144 chambers; 22 assorted dippers; 40 assorted 
covers; 22 cuspidors; 14 pudding pans; four scoops; 11 coffee 
pots; two funnels; four saucepans; four liquid measurers; five 
dustpans. 

Galvanized Ironware 

Twenty-nine buckets with new bottoms; seven potato boilers 
with new bottoms; 21 garbage cans with new bottoms; four rubbish 



Manhattan State Hospital, East, Ward's Island. 58 

cans with new bottoms; two 20-gallon cans with new bottoms; 
three drip pans with new bottoms; lined three ice boxes; lined 
three water-coolers; 22 buckets; three potato boilers; 19 garbage 
cans; nine rubbish cans; two skimmers; eight ice boxes; two 
20-gallon cans; three coal scuttles; seven drip pans; five 100-gallon 
tanks; one oil pump; two water-coolers; 13 wire screens. 

Black Ironware 
Two oil stoves; one fire-escape; seven window guards; 25 invalid 
tables; one ice cream freezer; two range doors; four oven doors; 
one operating table; two pairs hinges; two grates; two registers, 
four camp stoves. 

Russia Ironware 
Eighteen roast pans; 80 bread pans. 

Copper Ware 
Two sprays; three strainers; one sterilizer; one boiler cover. 

Repaired the following 

Brass Ware 
Fifty-seven medicine trays; two pairs hinges; five bird cages; 
three shoe patterns; two nozzles; one spring bolt; one oil can; 
one syringe; two bibs; two tea kettles; one flower stand. 

Miscellaneous 
Changed 20 locks ; changed four locks (Yale) ; 432 assorted locks ; 
19 Yale locks; 95 pairs door knobs; 110 pairs scissors; 102 keys; 248 
keys; one stamp; 54 clocks; 65 lanterns; 195 knives; one butter 
machine; two meat choppers; one punching press; one printing 
press; numbered 85 cans; nine bread cutters; one scale; one raisin 
cleaner; one saw setter; six hypodermic needles; one hair-clipping 
machine; 19 pairs spectacles; three safety razors; one truss; one 
typewriting machine; one clarinet; one copying machine; one 
grass clipper; one lawn mower; one officer chair; four lawn sprink- 
lers. 

Roofing Work 
Made 268 feet galvanized iron leaders, assorted, 14 galvanized 
iron elbows; two galvanized iron caps; one galvanized iron collar; 
five galvanized iron leaders; 189 feet galvanized iron gutter mould- 
ings; 20 feet galvanized iron window caps; 151 feet tin gutter 
linings ; assorted 40 feet zinc flashings ; 500 zinc babies ; put new roof 



54 Ninth Annual Report of the 

on wagon shed; (extension) engine shed and water-closet north 
from hospital. Put on new tar-paper roof on chicken-house; repaired 
and painted roof, gutters and leaders on hospital and passageway 
from hospital to main building. Repaired and painted all gutters 
and leaders, wards 8, 9, 11, 12 and 22. Repaired leaks on roofs on 
tinshop, ward F, water-closet (attendant's home), bakery and hook 
and ladder shed. Repaired leaders on boiler-house, laundry, stable, 
band room and north greenhouse. Cleaned chimney (staff kitchen) 
and all ranges in main and east building. 

PAINTER'S REPORT 

Painted interior fire-proof stairways, east building; painted 
dining room, ward 18, side walls and ceilings, also cleaned off all 
woodwork and refinished same; painted new storerooms, also 
passageway, south end basement, main building; painted wash, 
rooms, ward 14, side walls and ceiling, varnished woodwork; painted 
east section, ward 16, tailor shop; painted doctor's bathroom, 
main building, ceiling and side walls, also varnished woodwork; 
calked and painted one row boat, " Patrol " ; painted and enameled 
operating rooms, east building, ceiling, side walls and woodwork; 
painted ward F, east building, side walls and woodwork, also oiled 
and waxed new flooring, painted hospital 1, side walls, ceiling and 
woodwork, also waxed floors, painted and scraped railings, front 
and rear, main building; painted main hall, east building, side walls 
and woodwork, also grained and varnished same; painted new 
engine-house, also ladder-house; cleaned off and refinished doors, 
main hall, main building ; re-gilded slabs, front and rear, main building ; 
scraped all woodwork, ward 12, ready for refinishing; painted 
515 beds, 208 bed springs, 286 bed blocks, 269 chambers, 108 cuspidors 
6 fire grenades (holder), 7 wooden boxes, 15 tin boxes, 6 water-coolers? 
9 fire-extinguishers, 359 benches, 12 head rests, 12 tables, painted 
and decorated, 9 canvas screens; painted 13 iron screens; stenciled 
122 baskets, 24 cans; painted and varnished 12 checker boards. 

MASON'S ANNUAL REPORT FOR THE YEAR ENDING 
SEPTEMBER 30, 1904 
Cut out plaster and put deafening in floor of ward F, east build- 
ing; cut out two doorways, put deafening in floor and repaired 
plaster for painting in operating-room in ward E, east building; 
repaired plaster on walls and ceilings in all wards in east building, 
also in dining-rooms; cut out one door and one window, repaired 
plaster for painting and set iron stairs in tailor shop, main building; 



Manhattan State Hospital, East, Ward's Island. 55 

repaired plaster for painting in old storeroom, ward 12, also in 
Hospitals 1 and 2; cut out new door- way in ward 12, main building; 
repaired plaster for painting, put deafening in floor and set slabs 
and base in staff bathroom; removed arch in ward 16 and replaced 
it with new one to correspond with other four; repaired two boilers 
in main boiler-house ; repaired three ovens in bakery ; paved areaway 
outside of storeroom; repaired plastering in all wards in main build- 
ing, also in church and gymnasium ; repaired cement floor in several 
places in main building; repaired plaster on walls and ceilings in 
attendant's home, also repaired cement floors in toilets and made 
general repairs throughout all buildings. 

ELECTRICIAN'S REPORT 

New work done during this year ending September 30, 1904, as 

follows : 

Wired and installed in mat shop 

Eight one-light brackets (complete). 
One D. P. snap switch. 

Wired and installed in drug store and storeroom 
10 drop lights (complete). 
Three S. P. snap switches. 

Wired and installed in sick room of ward 2 
Six ceiling lights (complete). 
Six single pole flush switches. 

Wired and installed in ward F, east building 
Eight two-light fixtures (complete). 
Two one-light fixtures (complete). 
One drop light. 
Two D. P. snap switches. 

Wired and installed in sick-room of ward E, east building 
Three ceiling lights (complete). 
Three S. P. snap switches. 

Rewired and installed in operating-room, east building 
One four-light pendant fixture (complete). 
Two one-light pendant fixture (complete). 
Two one-light wall brackets (complete). 
One extension portable lamp (complete). 
Three S. P. snap switches. 
One 2 x 3 S. B. cut-out. 



56 Ninth Annual Report of the 

Wired and installed in jour new tents, size 20 by 40 
16 six-ft. pendants (complete). 
Four two-wire straight line cut-outs. 
Four S. P. snap switches. 
Eight No. 14, wire connectors. 

Wired and installed in main hall, east building 
One three-light fixture (complete). 
Four one-light fixtures (complete). 
One one-light bracket (complete). 
One D. P. flush switch. 

Wired and installed in ward E, east building 
One three-wire circuit. 
Two drop lights. 
One night light. 
One S. P. snap switch. 

Wired and installed in lower dining-room, east building 
Eight drop lights (complete) . 
One S. P. snap switch. 

Wired and installed in ward E, dining room, east building 
One S. P. snap switch. 
Changed wire. 

Wired and installed in ward A, dining-room, east building 
One S. P. snap switch. 
Changed wire. 

Re-wired and installed in main basement, east building 

Three drop lights (complete). 

Run one new three-wire circuit to feed wards E and A dining- 
rooms, ward E dormitory, lower dining-room, women's bathroom 
and linen-room ; ran ward 1 feed lines on knobs to distributing box. 

Re-wired and installed in doctor's room, east building 
One two-light fixture. 
Four one-light brackets. 
Three S. P. snap switches. 
One 3x2 D. B. cut-outs. 



Manhattan State Hospital, East, Ward's Island. 57 

BLACKSMITH SHOP REPORT OF ARTICLES MANUFAC- 
TURED AND REPAIRED FROM OCTOBER 1, 1903 ; TO 
SEPTEMBER 30, 1904 

Manufactured 

New platform and stairs in tailor shop 1 

New slip links 125 

New saddle hooks 40 

New tent hooks. 1,200 

New slice bars for boilers 6 

New pipe clamps, pipe fitters 150 

New toe calks made, pounds 250 

New pipe hangers 200 

New fire hoes 6 

New S hooks 150 

New window guards 4 

New bed springs put on 200 

New horseshoes put on 728 

Iron cleats for wardrobes 50 

New window screens . . 12 

Fire hoe wrenches , 50 

Repaired 

Window guards 20 

Wagons and carts 30 

Picks, laid and steeled 200 

Stillson wrenches 4 

Iron beds 250 

Old shoes calked and reset 320 

Window guards 10 

Wagon tires reset 12 

Cart tires reset 15 

Cold chisels sharpened 200 

Rock drills sharpened 50 

Wheelbarrows 200 

Fire hoes for boilers 12 

Window screens 50 

Forks, all kinds 40 

Slice bars for boilers 4 

Saddle hooks 30 



58 Ninth Annual Report of the 

i 

CARPENTER'S REPORT 

Main Building 

Ward 12: Made a general overhauling; removed all base in 
hall bedrooms and dining-room. Removed all raised moulding in 
patients' bedrooms and repaired the remaining door and window 
casing. Laid new floor in the hall, bedrooms and dining-room 
Put up new base in the hall, linen-room and dining-room. Put new chair 
rail in dining-room and repaired same in the hall. Put new door 
saddles at every door and repaired all the doors, also made one new 
door and frame at new fire-escape. Repaired all the windows and 
guards and put in sash cords where it was needed. 

New tailor shop: Made doors and frames for north and south 
entrances, also new window and door in partition in same. Put up 
table the whole length of the shop from stairs to about 10 feet from 
south end door. Made closets and shelves and racks for clothes. 

Built one large scaffold in windows in ward 12 for roofers to work 
on, and a smaller one on ground at ward 12, to use for laborers to 
bring up material to ward 12. 

Record room: Removed all woodwork for masons, and repaired 
all doors and door frames, windows and sash cords. Put new 
shelves in two rooms and repaired one sideboard. Put on all new 
locks and butts on doors. Put up two partitions in storeroom, 
hospitals 1 and 2. Made a general overhauling. Repaired all doors 
and windows and door and window frames. Repaired and put in 
new wire cloth in nearly all window screens. Repaired drawers and 
shelves in linen-room. Repaired all woodwork in elevator shaft, 
and put in new panels, etc., in the elevator. 

Built one large closet in photographer's office and made three 
plate holders for same. Repaired and put in new wire cloth in nearly 
all window screens in main building. 

Built partition in water-closet at matshop, also put up shelves 
and brackets for tanks in same. Repaired several windows, win- 
dow castings and guards in ward 19. 

Made a general overhauling of the food trucks. Repaired four 
office desks. Made nine boxes for electrical shop, also 11 boards. 
Made seven dipper handles for kitchen. 

Repaired floor in patients' room, ward 15. Repaired scale box 
for main kitchen. Repaired blacking box, ward 2. Put up mirror 
in ward 2. Put in door saddles in lower dining-room. Repaired 
railing in west end of church. Repaired gutter in southwest side 
of hospital 2. Made new plate washer for main kitchen. Repaired 



Manhattan State Hospital, East, Ward's Island. 59 

skylight in main kitchen. Made six barrel covers for main kitchen. 
Replaced door moulding at elevator shaft, ward 14. Made one box 
for Dr. Rowe's office to hold paper. Built one scaffold in church 
for glazier to work on. Made one hip rest and back rest for hospital 
and repaired stretchers for same. Made four carving boards for 
main kitchen. Repaired pipe cover for ward 6, second floor, main 
building. Made alteration in priest's clothes closet in the church. 
Made shelves for fire extinguishers in storeroom. Made new shelves 
in storeroom. Fastened closet to wall in steward's office. Repaired 
floor in ward 6. Repaired floor in patients' room, ward 2. Made 
box for brick to put stove on in new tailor shop. Repaired gate and: 
railing in stewards' office. Repaired dumb-waiter in main kitchen. 

Main kitchen: Made one box to hold chicken boxes. Made one 
stand to hold meat boxes. Repaired brackets for tanks and flush 
chain closet. Put up hooks in toilet-room, ward 7. Repaired 
shelves in storeroom, ward 18. Repaired two meat blocks in main 
kitchen. Repaired elevator in drug store. Repaired guard on 
fire-escape, east wing, main building. Repaired one artificial leg 
for patient, ward 14. Put up extra window guard bars in recess, 
ward 20. Made plugs for sewer traps, wards 13, 18 and 21. Made 
new cover for manhole over sewer pipe, wards 13, 18 and 21. Made 
rack to hold ward boxes, main kitchen. Repaired one dresser 
in staff apartments. Repaired baseboard in ward 7. Made one 
box for staff. Braced valves and traps under basins in wards 
14, 19 .and 22. Repaired step ladder in main kitchen. Made new 
bridge for food trucks under ward 2. Repaired moulding at four 
places in ward 6. Repaired long handled shovel for ward 23. 
Repaired stepladder, ward 23. Repaired floor in ward 4. Re- 
paired knife box for ward 6. Put sash fasteners on windows in store- 
room. Put up brackets to support fire hose in wards 1 and 8. 

Ward F : Laid floor in whole ward. Repaired all the' doors and 
door casing. Put new locks on all the doors, and put in all new 
door saddles. Put in all new base in the halls and recess, Repaired 
the chair rail and picture moulding all through the ward. Put 
in all new parting strips and sash stops and repaired window stools 
and sills in all the windows in the'ward. Put in new shelves and 
closets in the linen room. Put up new clothes hooks in wash room 
and toilet room. 

Main hall east building: Repaired floor and put in all new base. 
Repaired all the doors and door casings in the hall. Made a 
general overhauling of the main stairway, and put up an extra 
support under the stairs. 



60 Ninth Annual Report of the 

Linen-room: Laid floor in three rooms in basement and repaired 
the floor in the fourth room. Re-nailed the ceiling in all the rooms, 
and put up new shelves in linen-room proper, also repaired the 
doors. 

Operating-room, east building: Laid new floors in two rooms, ■ 
and repaired all the doors and windows. Put shelf in two closets, 
also one scaffold outside the window while repairs were going on. 
Repaired piano, upper dining room. Repaired coal box at east 
kitchen. Repaired spoon chest in lower dining-room, east building. 
Changed and repaired drain board in east kitchen. Put in clothes 
closet, ward A. Repaired floor in ward E. Put up hooks in clothes 
closet, ward A. Made broom rack for east building. Repaired 
floor in lower dining-room. Made one clock case for east building. 
Repaired rat holes on fourth floor, east building. Repaired wall 
in ward C. Repaired fire boxes in basement, east building. Hung 
mirrors in ward C. Removed blind escutcheons from doors of fire- 
escapes, east building. Repaired stairs leading to ward 1. Repaired 
floor in toilet, east building. Screwed fast one window in ward F. 
Made closets to hold steam pipes in ward E. Repaired all the 
furniture belonging to ward F. Repaired window shutters for Dr. 
Rowe's kitchen. 

Camps: Made extra stakes for Camp C, also repaired medicine 
chest for same. Made one box for Camp A to hold soiled clothes. 
Made five clock stands for camps. Repaired revolving tent at 
Camp A. Put new shelving in Camp B. Made new pail rack for 
Camp C. Repaired one post at Camp A. Made one new medicine 
chest for Camp B. Repaired platforms at Camp A. Made all plat- 
forms, shelves, boxes, board walks and water closet for new camp 
(E). Made two platforms, 20 feet by 40 feet; one platform, 12 feet by 
12 feet, and one platform 9 feet by 9 feet, and necessary board walk; 
also laid floor in water-closet at Camp D. Made five dozen stakes 
for Camp A. Put in new awning hooks in platforms, Camp B- 
Made 125 stakes for camps. Repaired floor in tent, Camp A. Made 
two boxes for camps. Made platform between the old tents at Camp 
D. Made one box for soiled clothes for Camp C. Made wire fence 
in front of Camp B. Repaired and put in place Camps A, B, C and D. 

Attendants' home: Put up shelves in room 2. Repaired floor 
in bathroom, second floor. Made brackets for shelves. Repaired 
bathroom, attendants 7 home, first floor. Repaired frame for 
bathtub, attendants' home. Repaired floor in old tailor shop in 
basement attendants' home. 



Manhattan State Hospital, East, Ward's Island. <M 

Outside work: Fire engine house; built one house for the fire 
engine, and made one box to cover the steam pipes from main boiler 
house to fire engine house. Made one closet for valves and traps 
for pipe leading to fire engine house, also repaired the hook and 
ladder shed. 

Carpenter shop: Built one ladder shed back of lumber shed for 
the ladders belonging to paint shop, and other ladders used by the 
institution's department. 

Greenhouses: Repaired benches and beds for the greenhouse at 
north garden, also repaired roof and benches at the east green- 
house. 

Repaired water-closet at exercise ground. Repaired fence, shed, 
gates, platforms and sluice at salt water baths. Repaired fence 
at back of attendants' home, rear of Camp B. down to the river, 
also gates at coal shed, below greenhouse. Assisted in taking 
up scales at coal dock. Repaired one cutting machine in tailor shop. 
Repaired window in shoe shop. Repaired cutting board in shoe 
shop. Repaired four boxes and four peel blades. Made pegs 
for knife box for printing machine. Repaired one camera. Fitted 
handles to 29 picks. Repaired washing machines in main laundry. 
Made one wooden block for bakery. Repaired one washing machine 
in east laundry. Repaired wall of tin shop. Repaired roof of 
shed at blacksmith shop. Repaired rack in shoe shop. Repaired 
stepladder for carpenter shop. Made four peels for bakery. Re- 
paired the doctor's salt water bath houses. Repaired wooden cover 
for stop cock at east building laundry. Made wood stand for ink 
in printing office. Repaired roof of bread room at bakery. Made 
four boards for book binding. Repaired three wagons, six carts 
and one truck for the stable. Repaired two hand carts for the 
laundry. Repaired one hand cart for Camp C. Repaired washing 
machine for east laundry. Repaired three washing machines 
for main laundry. Repaired and put up 62 wheelbarrows. 

Stable and barn: Repaired wall of Dr. Macdonald's cow-barn. 
Made cover pipe at barn. Repaired three stalls in the stable. Re- 
paired doors at cow^-barn. 

Changed and put in 134 pass locks. Repaired 38 wardrobes. 
Repaired 12 washstands. Replaced 548 sash cords. Replaced 
31 wardrobe locks. Replaced 12 drawer locks. Replaced 6 Yale 
locks. Put on 10 padlocks. Repaired 7 iceboxes. Put 49 pairs 
of knobs on doors. Put in place 39 toilet-paper holders. Repaired 
12 window guides. Repaired 21 sink boards. Filed 16 saws for 
butcher shop and the farm. Repaired 6 bread knives. Put 50 



62 Ninth Annual Report of the 

escutcheons on doors in main building. Repaired 8 and made 4 
floor polishers. Repaired 50 rocking chairs. Repaired 322 chairs. 
Repaired 248 settees. Made 24 checker boards. Made 22 tables- 
Repaired 61 tables. Repaired 48 windows. Made 13 window poles. 
Replaced 15 door saddles. Made 4 and repaired 180 doors. Re- 
paired 10 bureaus. Repaired 4 lounges. Made 22 towel roller swith 
racks. Made 20 bed screens and repaired 19. Made 12 and repaired 
18 closet seats. Repaired 7 Klondike tables. All the windows were 
taken out for cleaning in the following places: Wards E, B, C and 
I; twice in the staff; twice in the upper dining-room, cast build- 
ing, and twice in the lower dining-room, east building.. 

FARM AND GARDEN PRODUCTS FOR THE YEAR ENDING 
SEPTEMBER 30, 1904 

Asparagus, bunches 9 , 941 

Beets, bushels 525f 

Beet greens, bushels 1 , 123 

Beans, butter, bushels 94 

Blackberries, quarts 46 

Cabbage, pounds 23 , 032 

Cauliflower, heads 1 , 464 

Celery, heads 10,345 

Carrots, bushels 283^ 

Chili peppers, quarts 190 

Cabbage sprouts, barrels 10 

Currants, quarts 457 

Egg plant, pounds 4,258 

Grapes, pounds 812 

Gooseberries, quarts 104 J 

Kale, bushels 37 

Kohl rabi, bushels 62} 

Lettuce, bushels 933 

Lima beans, bushels 613 

Leeks, bushels 475£ 

Mint, bunches 564 

Muskmelons 5 , 407 

Milk, quarts 28,080 

Onions, bushels 1 , 023^ 

Onions, bunches 2 , 477 

Okra, bushels U 

Potatoes, bushels 10 

Parsnips, bushels 198f 



Manhattan State Hospital, East, Ward's Island. 63 

Peas, bushels 136 

Peppers, bushels 3£ 

Parsley, bushels 41f 

Parsley, bunches 48 

Pickles 7,288 

Peaches, bushels 25^ 

Pears, bushels 4 

Radishes, bushels 683£ 

Radishes, bunches 17 

Rhubarb, bunches 10 , 362 

Raspberries, quarts 70 

Soup, celery, bushels 176 

Spinach, bushels 561^ 

String beans, bushels 264f 

Sweet corn, ears 25 , 882 

Squash, pounds 1 , 330 

Swiss chard, bushels 951^ 

Salsify, bushels 77 

Strawberries, quarts 4 , 459 

Turnips, bushels >'. 388f 

Tomatoes, bushels 1 , 052^ 

Tomatoes, green, bushels 24^- 

Thyme, bunches 930 



FARM STOCK FOR THE YEAR ENDING SEPTEMBER 

30, 1904 

Horses 14 

Cows 12 

Bulls 1 

Heifers 3 



GENERAL INFORMATION DIRECTORY-MANHATTAN 
STATE HOSPITAL, EAST 

All official communications with regard to the Manhattan State 
Hospital, East, should be addressed to the superintendent. Post- 
office address, Ward's Island, Station U, New York city. 

Telephone, 1872 Harlem. 

Accessible by steamer from foot of East One Hundred and Sixteenth 
street, 1 p. m. 

Visiting days, Mondays, Tuesdays, Fridays and Saturdays. 

Visiting hours, 1 to 3 p. m. 



64 Ninth Annual Report of the 

VISITING OF PATIENTS 
Extracts from Regulations 

The superintendent shall regulate and determine the times at 
which patients may be visited by their friends ; and no visitor shall 
be allowed to see a patient without his consent. 

Friends of patients will be allowed to see them when their condi- 
tion admits of it, but each patient may only be visited once in two 
weeks, unless special permission is given by the superintendent, 
on account of the patient's illness or for other sufficient reason. 

Visitors will not be admitted on Sundays unless by special pass 
from the superintendent, and then only from 1 to 3 p. m. 

Visitors are expressly forbidden to furnish money, wine, liquor 
or tobacco to any inmate of the hospital, or to deliver to or receive 
from a patient any letter, parcel or package, without the knowledge 
and permission of the superintendent. 

No attendant shall receive any perquisite or present from any 
patient or friend of a patient, or sell to or buy anything from a patient. 

The physicians attached to the hospital will attend in the offices 
at the usual visiting hours, and will cheerfully and fully answer 
all questions addressed to them as to the condition and prospects 
of the different patients. Friends of patients are requested to apply 
to the physicians for information, and not to the attendants, who 
are not qualified to judge of such matters. Letters of inquiry 
should be addressed to the superintendent and will be promptly 
answered. 

Friends of patients should give notice of any change of residence, 
in order that they may be notified without delay in the event of 
the patient's death. 

Visits from others than relatives of patients will only be per- 
mitted when satisfactory evidence is presented that such visits have 
the sanction of the patient's nearest relative. 

Visits from committees of lodges or benevolent societies made 
with the view of testing a patient's sanity, will on no account be 
permitted. The superintendent will certify as to the patient's con- 
dition whenever such certification is needed. 

Visitors of all kinds must first apply at the office of the superin- 
tendent, and are forbidden to enter the wards or other parts of the 
hospital buildings in any other way. 

ADMISSIONS 

The following rules must be observed in the removal of patients 
to the Manhattan State Hospital East: 



Manhattan State Hospital, East, Ward's Island. 65 

1. Patients must be in a condition of bodily cleanliness. 

2. Patients must be provided with the following: 

(a) One full suit of underclothing. 

(b) One full suit of outer clothing, including headwear, boots 
or shoes. 

Between the last day of October and the last day of March there 
shall be provided, in addition to the foregoing, a suitable overcoat 
for men patients and a suitable shawl or cloak for women patients; 
also gloves. Considering the great danger, always present, of the 
introduction of contagious or infectious diseases into institutions 
where large numbers of people are congregated, and to avoid, as far as 
possible, the introduction of such diseases by means of wearing 
apparel, the clothing referred to above must, in all cases, be new. 

The superintendents of the State hospitals may waive the re- 
quirements of new clothing in the case of patients received from their 
homes, using their judgment as to said clothing being suitable as 
required by law. 

CORRESPONDENCE OF PATIENTS 

Each patient is permitted to write to some relative or friend 
once in two weeks, and oftener, if necessary, in the discretion of the 
superintendent. In the case of patients unable from any cause to 
write, the superintendent directs some proper person to write for 
such patients at suitable intervals if they so desire. 

All letters are forwarded at once, unless they are obscene, profane, 
illegible or too incoherent to be understood, and the postage is 
furnished by the hospital. 

Letters detained for the reasons stated above are forwarded 
at once to the office of the State Commission in Lunacy. 

Letters addressed to the Governor, Attorney-General, judges 
of courts of record, district attorneys, or the State Commissioners in 
Lunacy, are forwarded at once without examination. 
5 



66 



Ninth Annual Report op the 



STATISTICAL TABLES 

TABLE No. i 
Showing movement of population for the year ending September 30, 1904 



Men 



Women 



Total 



Remaining October 1, 1903 

Admitted during year ending September 30, 

1904 

On original commitments 

By transfers from other institutions for insane 

Total number under treatment during year. . 

Daily average population 

Capacity of institution 

Discharged during year: 

As recovered 

As improved 

As unimproved 

*As not insane 

Died 

Whole number discharged during year 

Remaining October 1, 1904 

♦Dotards. 



1,361 



602 
544 

58 



1,963 



1,457 
925 



68 
168 

55 

2 

204 



497 



1,466 



500 
69 
69 



569 



500 
500 



5 

46 

18 



1,861 

671 

544 
127 



2,532 



1,957 
1,425 



68 

173 

101 

2 

222 



69 566 



500 1,966 



Manhattan State Hospital, East, Ward's Island. 67 

TABLE No 2 
October i, 1903, to September 30, 1904 

Date of opening 1896 

Total acreage of grounds and buildings 119 

Value of real estate, including buildings $1 ,729,827 83 

Value of personal property 142,058 15 

Acreage under cultivation 531 

Receipts during year, maintenance fund: 

Balance on hand October 1, 1903 $1 ,059 12 

From State treasury for maintenance on estimates, 

1 to 12 inclusive 346,607 40 

From reimbursing patients 7,951 76 

From all other sources 478 21 

Total receipts for maintenance $356 , 096 49 

Total receipts from State Commission in Lunacy for 

extraordinary improvements $20 , 684 40 

Total receipts from manufacturing fund (inc. bal. of 

$4,301.28) $14,458 79 

Disbursements during year for maintenance: 

Estimate No. 1. For officers' salaries $19,881 84 

Estimate No. 2. For wages 112,810 47 

Estimate No. 3. For provisions and stores 125,53193 

Estimate No. 4. For ordinary repairs 8,529, 89 

Estimate No. 5. For farm and grounds 4,747 99 

Estimate No. 6. For clothing of patients 17,942 77 

Estimate No. 7. For furntiure and bedding 10,637 22 

Estimate No. 8. For books and stationery 2,930 01 

Estimate No. 9. For fuel and light 25,384 13 

Estimate No. 10. For medical supplies 2,484 24 

Estimate No. 11.* For miscellaneous expenses 9,291 22 

Estimate No. 12. For transportation 135 55 

Total disbursements, estimates 1 to 12 inclusive $340,307 26 

Remitted to State treasurer $7 ? 382 76 



68 Ninth Annual Report of the 

Total disbursements during year for extra- 
ordinary improvements under apportion- 
ments by State Commission in Lunacy $20 , 684 40 

Total disbursements during year, manufactur 
ing fund , . . . . 

Balances October 1, 1904: 

General maintenance fund 

Manufacturing fund 

Weekly per capita cost on daily average number of 
patients, estimates 1 to 12 inclusive 

Maximum rate of wages paid attendants: 

Men, per annum 

Women, per annum 

Minimum rate of wages paid attendants: 

Men, per annum $240.00 

Women, per annum 192 00 

Proportion of day attendants to average daily pop- 
ulation 1 to 9 . 5 

Proportion of night attendants to average daily 

population 1 to 40 

Percentage of daily patient population engaged in 

some kind of useful occupation 42.62 

Estimated value of farm and garden products during 
year $7,620 67 

Estimated value of articles made or manufactured by 

patients during year 44,908 56 



$10,762 15 


$8,406 47 
3,696 64 
f 

3.3257 


$420 00 
360 00 



Manhattan State Hospital, East, Ward's Island. 69 

TABLE No. 3 

Showing the assigned causes of insanity in cases admitted during the 

current year 



CAUSES 



Moral : 

Adverse conditions (such 
as loss of friends, busi- 
ness troubles, etc.). . . . 

Mental strain, worry and 
overwork (not included 
in above) 

Religious excitement. 

Love affairs (including se- 
duction) 

Fright and nervous shock 
Physical : 

Intemperance 

Sexual excess 

Venereal diseases 

Masturbation 

Sunstroke 

Accident or injury 

Fevers 

Privation and overwork. . 

Epilepsy 

Diseases of skull and 
brain 

Old age 

Abuse of drugs 

Loss of special sense. . . . 

All other bodily disorders 
and ill health 

Hereditary 

Congenital defect 

Unascertained 



Total. 



Year Ending Septem- 
ber 30, 1904 



Men Women Total 



25 



51 

1 

8 
9 

108 
13 
68 
27 

3 
16 

4 
22 
14 



6 
6 
1 

25 

40 

2 

153 

602 



30 



69 



29 



57 
2 

11 
10 

113 
13 
69 
28 

3 
16 

5 
25 
14 



7 
6 

1 

32 

45 

2 

183 

671 



Inherited Predispo- 
sition 



Men Women Total 



15 



3 
2 

22 
4 



3 

32 

3 



109 



15 



5 
2 

22 
4 



3 

36 

3 



115 



Unas- 
cer- 
tained 



18 



16 
1 

1 
2 

28 
3 

12 
5 



102 



70 



Ninth Annual Report of the 



TABLE No. 4 

Showing forms of insanity in those admitted, recovered and died during the 
year ending September 30, 1904, and since October 1, 1888 





Year Ending September 
30, 1904 


Since October 1, 1888 


FORM 


a 

< 


u 

> 



09 


5 

s 


T3 



i 

< 


73 
V 

u 

> 
O 
O 


-a 

s 


Mania, acute 

Mania, recurrent 


63 


21 


13 

4 
18 

11 


1,527 
43 

217 

4,031 

60 

1,037 

116 
2,176 

569 
2,166 

391 

280 

7 


341 
5 
4 

902 

6 
70 

4 


336 
3 


Mania, chronic 


10 

148 

73 

37 
131 

45 
138 

19 

5 


47 


100 


Melancholia, acute 

Melancholia, simple. 
Melancholia, chronic ... 
Paranoia 


487 

213 

2 


General paralysis 

Dementia, primary 

Dementia, terminal 

Epilepsy with insanity . . 
Imbecility with maniacal 
attacks . . 




99 

1 

75 

1 


1,532 
101 

1,309 
177 

40 


Idiocy 






3 


Not insane* 


2 






15 















* Includes cases of alcoholism, drug habit, etc. 



TABLE No. 5 

Temporarily discontinued 



Manhattan State Hospital, East, Ward's Island. 



71 



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72 



Ninth Annual Report op the 



TABLE No. 7 

Showing the causes of death of patients who died during the current year 
and since October i, 1888 



CAUSE OF DEATH 



Year Ending Sep- 
tember 30, 1904 



Specific infectious dis- 
eases : 

Typhoid fever 

Mumps 

Erysipelas 

Septicemia and pye- 
mia 

Malarial affections . . 

Tuberculosis 

Diseases of the digestive 
system : 

Mouth, salivary 
glands, pharynx, 
tonsils and oesoph- 
agus 

Diseases of the 

stomach 

Diseases of the in- 
testines 

Diseases of the liver. 
Diseases of the peri- 
toneum 

Diseases of the respira- 
tory system : 

Diseases of the nose 

and larynx 

Diseases of the 

bronchi 

Diseases of the lungs 
Diseases of the 

pleura 

Diseases of the circula- 
tory system : 

Diseases of the peri- 
cardium 

Diseases of the heart 
Arterio-sclerosis .... 
Aneurism 



22 



23 



12 



3 

39 



30 
4 



12 



Since October 1, 1888 



6 

44 



34 
6 



2 
1 

7 

41 
1 

89 



2 
3 

309 

28 

14 



65 

842 

10 



3 

361 

94 

5 



4 
17 



Manhattan State Hospital, East, Ward's Island. 73 

Table No. 7 — {Continued) 



CAUSE OF DEATH 



Diseases of the blood and 
ductless glands : 

Diseases of the 
genito-urinary 

system 

Diseases of the nervous 
system : 

Diseases of the 

spinal cord 

Diseases of the men 



mges . . . _ 

Organic diseases of 
the brain (tumor, 
abscess, embol- 
ism, thrombosis, 
hemorrhage and 
other gross le- 
sions) 

Functional nervous 
diseases (paralysis 
agitans, chorea, 
eclampsia, hys- 
teria, neurasthe- 
nia) 

Epilepsy 

"Mental diseases: 

Exhaustion of acute 

mental disease 

Exhaustion of chronic 

mental disease 

General paralysis of 

the insane 

The intoxications; heat- 
stroke ; obesity : 

Metallic poisoning . . 
Debility of old age. . . 

Accident 

Suicide 



Year Ending Sep- 
tember 30, 1904 



16 



61 



16 



61 



Since October 1, 1888 



312 

20 
70 



197 



2 

164 



204 



1,287 



3 
22 
10 
29 



316 

20 
70 



200 



2 

164 



204 



1,294 



3 
22 
10 
30 



74 



Ninth Annual Report of the 
Table No. 7 — {Continued) 





Year Ending Sep- 
tember 30, 1904 


Since October 1, 1888 


CAUSE OF DEATH 


a 
o 


{A 

a 

o 


o 




a 

V 

S 

o 


"3 

o 


Surgical and gynecolog- 
ical diseases and dis- 
eases of the skin 

Malignant new growths 
or cancer 


1 

2 
204 


1 

2 


2 

4 


4 
18 


1 

2 


5 
20 






Total 


18 


222 


4,220 


83 


4,303 





TABLE No. 8 

Showing hereditary tendency to insanity in patients admitted during the 

current year and since October i, 1888 





Year Ending September 
30, 1904 


Since October 1, 1888 




Men 


Women 


Total 


Men 


Women 


Total 


Paternal branch 

Maternal branch 

Paternal and maternal 
branches 


23 
37 

2 

53 

383 

• 104 


2 
2 

2 
53 
10 


25 
39 

2 

55 

436 

114 


447 

428 

46 

637 

7,280 

3,118 


18 
24 

"39 
359 

282 


465 
452 

46 


Collateral branches 

No hereditary tendency. . 
Unascertained 


676 
7,639 
3,400 






Total 


602 


69 


671 


11,956 


722 


12,678 







Manhattan State Hospital, East, Ward's Island. 



75 



TABLE No. 9 

Showing civil condition of patients admitted during the current year and 

since October i, 1888 





Year Ending September 
30, 1904 


Since October 


1, 1888 


CIVIL CONDITION 


Men 


Women 


Total 


Men 


Women 


Total 


Single 


339 

228 

28 

1 

6 


35 
25 

8 
1 


374 
253 

36 
2 

' 6 


6,331 
4,597 

858 

27 

143 


271 

299 

146 

2 

4 


6,602 


Married 


4,896 
1,004 


Widowed 


Divorced 


29 


Unascertained 


147 






Total 


602 


69 


671 


11,956 


722 


12,678 



TABLE No. 10 

Showing degree of education of patients admitted during the current year 

and since October 1, 1888 





Year Ending September 
30, 1904 


Since 


October 


L, 1888 


DEGREE OF EDUCATION 


Men 


Women 


Total 


Men 


Women 


Total 


Collegiate 


10 

6 

321 

171 

14 

31 

49 


"40 

18 
2 
4 
5 


10 
6 

361 

189 
16 
35 
54 


230 

169 
4,561 
5,156 

253 

789 
798 


1 

212 

370 

32 

63 

44 


230 


Academic 


170 


Common school 


4,773 


Read and write 


5,526 


Read only 


285 


No education 


852 


Unascertained 


842 






Total... 


602 


69 


671 


11,956 


722 


12,678 







76 



Ninth Annual Report of the 



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Manhattan State Hospital. East, Ward's Island. 



77 



TABLE No. 12 « 

Showing ages of those admitted during the current year and since 

October i, 1888 





Year Ending September 


Since October 1, 1888 






30, 1904 








AGE 














Men 


Women 


Total 


Men 


Women 


Total 


From 10 to 15 years. . . . 








39 




39 


From 15 to 20 years .... 


35 




35 


640 


2 


642 


From 20 to 25 years .... 


57 


4 


61 


1,459 


12 


1,471 


From 25 to 30 years .... 


94 


7 


101 


1,715 


44 


1,759 


From 30 to 35 years .... 


96 


16 


112 


1,779 


80 


1,859 


From 35 to 40 years .... 


82 


10 


92 


1,658 


84 


1,742 


From 40 to 50 years .... 


132 


21 


153 


2,321 


184 


2,505 


From 50 to 60 years .... 


72 


8 


80 


1,330 


148 


1,478 


From 60 to 70 years 


24 


3 


27 


683 


109 


792 


From 70 to 80 years .... 


8 




8 


235 


44 


279 


From 80 to 90 years .... 








64 


13 


77 


Ninety years and over . . 








13 




13 


Unascertained 


2 




2 


20 


2 


22 


Total 


602 


69 


671 


11,956 


722 


12,678 







TABLE No. 13 

Showing ages of those discharged recovered during the current year and 

since October 1, 1888 





Year Ending Septembfr 
30, 1904 


Since October 1, 1888 


AGE 


Men 


Women 


Total 


Men 


Women 


Total 


From 10 to 20 years .... 
From 20 to 30 years .... 
From 30 to 40 years .... 
From 40 to 50 years .... 

From 50 to 60 years 

From 60 to 70 years .... 
From 70 to 80 years .... 


12 
23 

18 

11 

3 

1 




12 
23 

18 

11 

3 

1 


104 

438 

410 

248 

88 

40 

1 

2 


1 


104 
438 
411 

248 

88 

40 

1 


Tiicrhfv vpars a.nd over. . 








2 












Total . . 


68 





68 


1,331 


1 


1,332 


__ . 5 





78 



Ninth Annual Report of the 



TABLE No. 14 
Showing ages of patients who died during the current year and since 

October 1, 1888 





Year Ending September 
30, 1904 


Since October 1, 1888 


AGE 


Men 


Women 


Total Men 


Women 


Total 


From 15 to 20 years . . . 
From 20 to 25 years . . . 
From 25 to 30 years . . . 
From 30 to 35 years . . . 
From 35 to 40 years . . . 
From 40 to 50 years . . . 
From 50 to 60 years . . . 
From 60 to 70 years . . . 
From 70 to 80 years . . . 
From 80 to 90 years . . . 


4 
7 

10 
31 
27 
61 
39 
18 
7 


1 

6 
2 
5 
4 


4 
7 

10 
32 
27 
67 
41 
23 
11 


62 

182 

316 

493 

633 

1,031 

740 

469 

221 

58 

15 


6 
4 
11 
21 
17 
17 
7 


62 
182 
316 
499 
637 
1,042 
761 
486 
238 
65 


From 90 upwards. . . . , 








15 












Total 


204 


18 


222 


4,220 


83 


4,303 







Manhattan State Hospital, East, Ward^s Island. 79 



TABLE No. 15 

Showing alleged duration of insanity previous to admission of patients 

admitted during the year ending September 30, 1904 



DURATION OF INSANITY 



Men 



Women 



Total 



Under one month 

One to three months 

Three to six months 

Six to nine months 

Nine months to one year 

One year to eighteen months. 
Eighteen months to two years 

Two to three years 

Three to four years 

Four to five years 

Five to ten years 

Ten to fifteen years 

Fifteen to twenty years 

Twenty to thirty years 

Thirty years and upwards 

Not insane* 

Unascertained 

Total 



80 

64 

49 

36 

6 

68 

15 

44 

27 

12 

42 

16 

6 

4 

1 

2 

130 



602 



5 
5 
5 
3 
5 
23 
3 
2 
1 



17 



69 



80 

64 

49 

36 

6 

73 

20 

49 

30 

17 

65 

19 

8 

5 

1 

2 

147 



671 



* Includes cases of alcoholism, morphia habit, etc. 



80 



Ninth Annual Report of the 



TABLE No. 1 6 

Showing period of residence in asylum of patients remaining under 

treatment September 30, 1904 



PERIOD OF RESIDENCE 



Men 


Women 


7 




21 


4 


108 


3 


113 


13 


118 


26 


176 


48 


136 


17 


199 


389 


95 




61 




193 




105 




75 




52 




7 




1,466 


500 



Total 



Under one month 

One to three months 

Three to six months 

Six to nine months 

Nine months to one year 

One year to eighteen months . 
Eighteen months to two years 

Two to three years 

Three to four years 

Four to five years 

Five to ten years 

Ten to fifteen years 

Fifteen to twenty years 

Twenty to thirty years 

Thirty years and upwards .... 

Total 



7 

25 

111 

126 

144 

224 

153 

588 

95 

61 

193 

105 

75 

52 

7 



1,966 



Manhattan State Hospital, East, Ward's Island. 81 



TABLE No. 17 
Showing the occupation of those admitted during the current year and since 

October 1, 1888 





Year Ending September 


Since 


October 


l, 1888 




30, 1904 








OCCUPATION 














Men 


Women 


Total 


Men 


Women 


Total 


Professional : 














Clergy, military and 














naval officers, physi- 














cians, lawyers, archi- 














tects, artists, authors, 














civil engineers, survey- 














ors, etc 


23 


1 


24 


416 


5 


421 


Commercial : 














Bankers, merchants, ac- 














countants, clerks, 














salesmen, shopkeepers, 














shopmen, stenogra- 














phers, typewriters, etc. 


108 


110 


2,040 


8 


2,048 


Agricultural and 














pastoral : 














Farmers, gardeners, 














herdsmen, etc 


3 




3 


230 




230 


Mechanics at out- 














door vocations: 














Blacksmiths, carpenters, 














engine-fitters, sawyers, 














painters, police, etc. . . . 


52 




52 


2,463 




2,463 


Mechanics, etc., at 














sedentary voca- 














tions : 














Bootmakers, bookbind- 














ers, compositors, weav- 














ers, tailors, bakers, etc. 


143 




143 


2,391 


2 


2,393 


Domestic service : 














Waiters, cooks, servants, 














etc 


65 


50 


115 


871 


541 


1,412 


Educational and 














higher domestic 














duties : 














Governesses, teachers, 














students, housekeep- 














ers, nurses, etc 


2 




2 


93 


38 


131 


Commercial : 














Shopkeepers, sales 














women, stenographers, 














etc 








19 


1 


20 



82 



Ninth Annual Report of the 
Table No. 17 — (Concluded) 





Year Ending September 
30, 1904 


Since October 1, 1888 


OCCUPATION 


Men 


Women 


Total 


Men 


Women 


Total 


Employed in seden- 
tary occupation : 
Tailoresses, seamstresses, 
bookbinders, factory 
workers, etc 


9 
10 


8 


17 
10 


9 
135 


47 

1 

69 
10 


56 


Miners, seamen, etc 

Prostitutes 


135 
1 


Laborers 


156 

26 
5 


7 
1 


156 

33 

6 


2,397 
632 
260 


2,397 


No occupation 


701 


Unascertained 


270 






Total 


602 


69 


671 


11,956 


722 


12,678 







Manhattan State Hospital, East, Ward's Island. S3 



TABLE No. 1 8 

Showing the nativity of patients admitted during the current year and since 

October i, 1888 



NATIVITY 



Year Ending Septembp:r 
30, 1904 



Men 



Women Total 



Since October 1, 1888 



Men 



Women Tot 



Africa 

Algeria 

Armenia 

Austria 

Bavaria 

Belgium 

Bohemia 

British possessions 

Bulgaria 

Canada 

China 

Cuba 

Denmark 

Egypt 

England 

Finland 

France 

Germany 

Greece 

Holland 

Hungary 

Ireland 

Italy 

Japan 

Malta 

Mexico 

Norway 

Roumania 

Russia Poland 

Sandwich Islands . . 

Scotland 

South America 

Spain 

Sweden 

Switzerland 

Turkey 



1 

1 

33 



16 
1 
6 

69 



2 
13 

87 

37 

1 



2 

7 
58 



22 
2 



1 

1 
36 



19 
1 
6 

76 



3 

13 

109 

39 

1 



2 

7 
61 



4 




4 




329 


.18 


9 




11 




62 


6 


32 


1 


1 




116 


6 


39 




8 




41 




2 





418 

20 

192 

2,028 

17 

28 

167 

2,096 

526 

5 

5 

4 

47 

34 

770 

1 

127 

8 

20 

163 

92 

24 



20 

1 

6 

141 



1 

8 

271 

13 



37 
2 



3 

4 

4 

347 

9 

11 

68 

33 

1 

122 

39 

8 

41 

2 

438 

21 

198 

2,169 

17 

29 

175 

2,367 

539 

5 

5 

4 

47 

34 

807 

1 

129 

■ 8 

20 

169 

99 

24 



84 



Ninth Annual Report of the 
Table No. 18— (Concluded) 



NATIVITY 


Year Ending September 
30, 1904 


Since 


October 1, 1888 


Men 


Women 


Total 


Men 


Women 


Total 


United States 


233 


25 


258 


4,407 
46 


173 4,580 


West Indies 


1 46 


Unascertained 


5 




5 


50 


5 55 








12,678 


Total 


602 


69 


6711 1 Q5fi 


722 









Of the total number admitted since the 1st of October, 1888, the 
parents of 86 per cent were both of foreign birth. 

In 2 per cent the parentage on the paternal side was foreign, 
while that on the maternal side was native. 

In 1.8 per cent the parentage on the maternal side was foreign, 
while that on the paternal side was native. 



Manhattan State Hospital, East, Ward^s Island. 85 



TABLE No. 19 

Showing the residence by counties and classification of patients admitted 
during the year ending September 30, 1904 



COUNTIES 


Public 


Private 


Total 


Albany 








Allegany ' 








Broome 








Cattaraugus 








Cavuga 








Chautauqua 








Chemung 








Chenango 








Clinton 








Columbia 








Cortland 








Delaware 








Dutchess 








Erie 








Essex 








Franklin '. 








Fulton 








Genesee 








Greene 








Hamilton 








Herkimer 








Jefferson 








Kings 


13 




13 


Lewis 




Livingston 


2 




2 


Madison 




Monroe 








Montgomery 








Nassau 








New York 


633 




633 


Niagara 




Oneida 








Onondaga 








Ontario 








Orange 








Orleans . 








Oswego 








Otsego 








Putnam 








Queens 


2 




2 


Rensselaer 




Richmond 


20 

1 




20 


Rockland 


1 


St. Lawrence 





86 



Ninth Annual Keport op the 



Table No. 19 — (Continued) 



COUNTIES ' 


Public 


Private 


Total 


Saratoga 








Schenectady 








Schoharie 








Schuyler ' 








Seneca 








Steuben 








Suffolk 








Sullivan 








Tioga 








Tompkins .' 








Ulster 








Warren 








Washington 








Wayne 








Westchester 








Wvominsf 








Yates 








Soldiers' Home 
















Total 


671 




671 







Manhattan State Hospital, East, Ward's Island. 87 



TABLE No. 20 

Showing the residence by counties and classification of patients remaining 



under treatment, September 30 


1904 






COUNTIES 


Public 


Private 


Total 


Albany 








Allegany 








Broome 








Cattaraugus 








Cavusra 








Chautauqua 








Chemung 








Chenango 








Clinton 








Columbia 








Cortland , 








Delaware 








Dutchess 




1 


1 


Erie 






Essex 








Franklin 








Fulton 








Genesee 








Greene 








Hamilton 








Herkimer 








Jefferson 








Kings 


10 




10 


Lewis 




Livingston 








Madison 








Monroe 








Montgomery 








New York 


1,433 


497 


1,930 


Niagara 




Oneida. . 








Onondaga 








Ontario 








Orange 








Orleans 








Oswego . -. . . . 








Otsego 








Putnam 








Queens 


2 


2 


4 


Rensselaer 




Richmond 


20 




20 


Rockland 




St. Lawrence 









88 



Ninth Annual Report of the 
Table No. 20 — {Continued) 



COUNTIES 


Public 


Private 


Total 


Saratoga 








Schenectady 








Schoharie 








Schuyler 








Seneca 








Steuben 








Suffolk 








Sullivan 








Tioga 








Tompkins . . 








Ulster 
















Washington 
















Westchester . 


1 




1 






Yates 
























Total 


1,466 


500 


1,966 







Manhattan State Hospital, East, Ward's Island. 89 

SPECIAL TABLE No. i 

Medical Service, September 30, 1904 

Number of physicians 14 

Ratio of physicians to patients 1 to 140 

Annual per capita cost of medical service $9.4593 



SPECIAL TABLE No. 2 

Employees, September 30, 1904 

Total number of employees 334 

Ratio of all employees to patients 1 to 5 . 86 

Ratio of attendants to patients 1 to 8 . 33 

Per capita cost of all employees $57 . 6445 



SPECIAL TABLE No. 3 
October 1, 1903, to September 30, 1904 

Recoveries 
Percentages : 

On number admitted (excluding transfers) 

On daily average population 

On whole number under treatment 

On number discharged (excluding transfers) 



SPECIAL TABLE No. 4 
October 1, 1903, to September 30, 1904 

Deaths 
Percentages : 

On number admitted (excluding transfers) 

On average daily population 

On whole number treated 

On number discharged (excluding transfers) 



12 


41 


3 


,47 


2 


.68 


15 


14 



40 


.51 


11 


,34 


8. 


.77 


49 


.44 



90 Report of the .Manhattan State Hospital, East. 

SPECIAL TABKE No. 5 

Average purchase price and per capita cost of staple articles of consumption 
for the year ending September 30, 1904 

Per 
Average price capita cost 

Meats, fresh, per pound $0.0647 $13.0191 

Poultry, per pound . 1456 . 6341 

Wheat flour, per barrel. 4.3013 6.2969 

Butter, per pound .2037 8.3561 

Cheese, per pound .0917 . 7356 

Milk, condensed, per quart . 1662 8.6607 

Milk, cow's, per quart .0450 .5781 

Eggs, per dozen * . 1865 3.6603 

Tea, per pound . 1938 . 5720 

Coffee, per pound 0965 1.2141 

Sugar, per pound .0466 2.4019 

Liquor, distilled, per gallon 2. 1117 .0351 



Cost of coal consumed for the year ending September 30, 1904 

Total annual cost $24,009.. 70 

Annual per capita cost 12 . 2686 

Number of tons of coal consumed 8,981 

Average purchase price $2 . 6774 



The HF Group 

Indiana Plant 
073070 H 53 00 



10/12/2006